Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.60 / $22.82 / $35.57	Facility	26	$17.60	$22.82	$35.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $69.11 / $240.80	Professional		$40.01	$69.11	$240.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $26.40 / $58.63	Professional	26	$19.04	$26.40	$58.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.66 / $33.83 / $105.00	Professional	TC	$20.66	$33.83	$105.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $47.16 / $60.05	Professional		$39.65	$47.16	$60.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $27.32 / $62.61	Professional	26	$20.23	$27.32	$62.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.45 / $24.45 / $42.78	Professional	TC	$24.45	$24.45	$42.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $45.20 / $58.82	Professional		$22.37	$45.20	$58.82
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $54.49 / $73.65 / $124.30	Professional		$54.49	$73.65	$124.30
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $26.00 / $26.73	Professional	26	$25.82	$26.00	$26.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.12 / $84.00 / $172.72	Professional		$47.12	$84.00	$172.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $29.37 / $55.34	Professional	26	$22.17	$29.37	$55.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.81 / $42.70 / $117.82	Professional	TC	$23.81	$42.70	$117.82
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $134.57 / $134.57	Facility	26	$85.90	$134.57	$134.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $505.35 / $562.97 / $562.97	Professional		$505.35	$562.97	$562.97
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.58 / $186.58 / $221.33	Professional	26	$186.58	$186.58	$221.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $342.11 / $399.92 / $399.92	Professional	TC	$342.11	$399.92	$399.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $79.47 / $197.62	Professional		$46.67	$79.47	$197.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $42.43 / $62.44	Professional	26	$31.11	$42.43	$62.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.95 / $48.53 / $129.40	Professional	TC	$37.95	$48.53	$129.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $45.66 / $101.99	Professional		$26.92	$45.66	$101.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.15 / $88.43 / $172.72	Professional		$48.15	$88.43	$172.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $28.26 / $52.17	Professional	26	$22.17	$28.26	$52.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.62 / $38.15 / $125.61	Professional	TC	$23.62	$38.15	$125.61
United Facility/Professional Professional Modifier Low / Median / High Price $49.91 / $71.89 / $119.66	Professional		$49.91	$71.89	$119.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $30.83 / $46.48	Professional	26	$23.54	$30.83	$46.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.47 / $36.38 / $88.27	Professional	TC	$24.47	$36.38	$88.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.24 / $56.65 / $79.91	Professional		$50.24	$56.65	$79.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $26.09 / $36.53	Professional	26	$22.63	$26.09	$36.53
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $30.56 / $43.92	Professional	TC	$27.61	$30.56	$43.92