Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $38.02 / $48.98	Facility	26	$34.67	$38.02	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $331.13	Professional		$69.18	$95.50	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $45.71 / $138.04	Professional	26	$33.11	$45.71	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $46.77 / $218.78	Professional	TC	$32.36	$46.77	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $125.89	Professional		$52.48	$74.13	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $69.18	Professional	26	$28.18	$38.02	$69.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $61.66 / $89.13	Professional		$28.84	$61.66	$89.13
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $144.54	Professional		$75.86	$107.15	$144.54
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $39.81 / $39.81	Professional	26	$35.48	$39.81	$39.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $42.66 / $61.66	Facility	26	$9.12	$42.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $218.78	Professional		$60.26	$93.33	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $83.18	Professional	26	$31.62	$44.67	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $47.86 / $141.25	Professional	TC	$27.54	$47.86	$141.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $1,000.00	Professional		$707.95	$707.95	$1,000.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $302.00 / $302.00	Professional	26	$239.88	$302.00	$302.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $549.54 / $776.25	Professional	TC	$549.54	$549.54	$776.25
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $38.02 / $48.98	Facility	26	$30.90	$38.02	$48.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $323.59	Professional		$70.79	$107.15	$323.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $51.29 / $112.20	Professional	26	$34.67	$51.29	$112.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $56.23 / $165.96	Professional	TC	$31.62	$56.23	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $63.10	Professional		$31.62	$33.11	$63.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $91.20 / $229.09	Professional		$38.90	$91.20	$229.09
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $42.66 / $61.66	Facility	26	$9.12	$42.66	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $204.17	Professional		$60.26	$93.33	$204.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $40.74 / $72.44	Professional	26	$31.62	$40.74	$72.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $45.71 / $138.04	Professional	TC	$27.54	$45.71	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $158.49	Professional		$61.66	$85.11	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $40.74 / $69.18	Professional	26	$32.36	$40.74	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $41.69 / $83.18	Professional	TC	$27.54	$41.69	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $95.50	Professional		$79.43	$79.43	$95.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $45.71	Professional	26	$36.31	$38.02	$45.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $41.69 / $48.98	Professional	TC	$39.81	$41.69	$48.98