Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.60 / $22.98 / $35.11	Facility	26	$17.60	$22.98	$35.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $65.06 / $156.16	Professional		$39.86	$65.06	$156.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $26.03 / $92.04	Professional	26	$19.38	$26.03	$92.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.94 / $25.72 / $102.22	Professional	52	$19.94	$25.72	$102.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.18 / $91.70	Professional	TC	$20.89	$33.18	$91.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.18 / $45.77 / $57.19	Professional		$39.18	$45.77	$57.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $26.33 / $58.01	Professional	26	$18.64	$26.33	$58.01
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $4.95 / $40.03 / $83.76	Professional	52	$4.95	$40.03	$83.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $22.74 / $22.74	Professional	TC	$22.74	$22.74	$22.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $43.41 / $59.90	Professional		$22.37	$43.41	$59.90
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $50.66 / $62.35 / $93.98	Professional		$50.66	$62.35	$93.98
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.53 / $27.73 / $46.20	Professional	26	$25.53	$27.73	$46.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.61 / $79.48 / $149.66	Professional		$48.61	$79.48	$149.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.50 / $28.26 / $52.14	Professional	26	$21.50	$28.26	$52.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.76 / $51.65 / $101.41	Professional	TC	$25.76	$51.65	$101.41
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $73.63 / $132.47 / $132.47	Facility	26	$73.63	$132.47	$132.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $447.95 / $456.91 / $482.48	Professional		$447.95	$456.91	$482.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $265.83 / $265.83 / $265.83	Professional	26	$265.83	$265.83	$265.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $398.99 / $406.97 / $406.97	Professional	TC	$398.99	$406.97	$406.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.39 / $78.79 / $189.34	Professional		$45.39	$78.79	$189.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.75 / $40.61 / $75.98	Professional	26	$32.75	$40.61	$75.98
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $158.60 / $158.60 / $158.60	Professional	52	$158.60	$158.60	$158.60
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.28 / $48.13 / $120.32	Professional	TC	$35.28	$48.13	$120.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $55.33 / $115.05	Professional		$31.57	$55.33	$115.05
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.61 / $81.11 / $161.88	Professional		$48.61	$81.11	$161.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.50 / $27.33 / $49.89	Professional	26	$21.50	$27.33	$49.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.76 / $49.18 / $101.41	Professional	TC	$25.76	$49.18	$101.41
United Facility/Professional Professional Modifier Low / Median / High Price $67.17 / $89.52 / $129.86	Professional		$67.17	$89.52	$129.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.19 / $28.95 / $44.85	Professional	26	$22.19	$28.95	$44.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.26 / $61.07 / $86.51	Professional	TC	$43.26	$61.07	$86.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $54.22 / $76.40	Professional		$48.03	$54.22	$76.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.36 / $25.80 / $36.11	Professional	26	$22.36	$25.80	$36.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.67 / $28.42 / $40.84	Professional	TC	$25.67	$28.42	$40.84