Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.72 / $18.39 / $33.08	Facility	26	$16.72	$18.39	$33.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $92.35 / $199.52	Professional		$73.34	$92.35	$199.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.02 / $24.94 / $60.56	Professional	26	$18.02	$24.94	$60.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.39 / $66.95 / $125.56	Professional	TC	$53.39	$66.95	$125.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.15 / $83.47 / $117.58	Professional		$69.15	$83.47	$117.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $25.03 / $45.13	Professional	26	$20.51	$25.03	$45.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $74.92 / $105.67	Professional		$21.28	$74.92	$105.67
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $93.07 / $114.98 / $197.56	Professional		$93.07	$114.98	$197.56
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $26.45 / $27.43	Professional	26	$24.26	$26.45	$27.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $104.54 / $191.66	Professional		$76.23	$104.54	$191.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $28.32 / $53.42	Professional	26	$21.21	$28.32	$53.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.16 / $75.92 / $144.57	Professional	TC	$54.16	$75.92	$144.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.02 / $126.11 / $126.11	Facility	26	$61.02	$126.11	$126.11
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $692.04 / $692.04 / $896.48	Professional		$692.04	$692.04	$896.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.29 / $165.29 / $207.90	Professional	26	$165.29	$165.29	$207.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $526.74 / $526.74 / $688.58	Professional	TC	$526.74	$526.74	$688.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $155.27 / $267.75	Professional		$90.95	$155.27	$267.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.22 / $37.36 / $99.64	Professional	26	$29.22	$37.36	$99.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $92.20 / $117.90 / $314.39	Professional	TC	$92.20	$117.90	$314.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.99 / $113.45 / $163.86	Professional		$31.99	$113.45	$163.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.41 / $109.77 / $220.69	Professional		$76.41	$109.77	$220.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.33 / $27.04 / $49.44	Professional	26	$21.33	$27.04	$49.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $53.59 / $75.92 / $133.97	Professional	TC	$53.59	$75.92	$133.97
United Facility/Professional Professional Modifier Low / Median / High Price $86.89 / $119.66 / $176.30	Professional		$86.89	$119.66	$176.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.52 / $29.56 / $44.58	Professional	26	$22.52	$29.56	$44.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.42 / $88.27 / $131.55	Professional	TC	$65.42	$88.27	$131.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $88.34 / $98.78 / $140.59	Professional		$88.34	$98.78	$140.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $24.50 / $34.29	Professional	26	$21.26	$24.50	$34.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $67.08 / $74.28 / $106.80	Professional	TC	$67.08	$74.28	$106.80