Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.09 / $30.02 / $46.41	Facility	26	$23.09	$30.02	$46.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.17 / $131.19 / $252.52	Professional		$98.17	$131.19	$252.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $32.57 / $96.07	Professional	26	$23.09	$32.57	$96.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.08 / $96.14 / $171.99	Professional	TC	$75.08	$96.14	$171.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $108.17 / $114.53	Professional		$80.45	$108.17	$114.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $58.59 / $81.70	Professional	26	$34.04	$58.59	$81.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.94 / $80.94 / $80.94	Professional	TC	$80.94	$80.94	$80.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $104.10 / $147.18	Professional		$29.19	$104.10	$147.18
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $185.28 / $256.54	Professional		$133.00	$185.28	$256.54
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $33.70 / $36.33	Professional	26	$33.70	$33.70	$36.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.05 / $153.30 / $282.39	Professional		$116.05	$153.30	$282.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $37.44 / $70.09	Professional	26	$28.94	$37.44	$70.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.00 / $113.03 / $216.57	Professional	TC	$86.00	$113.03	$216.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $84.74 / $175.47 / $175.47	Facility	26	$84.74	$175.47	$175.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $968.58 / $968.58 / $1,227.45	Professional		$968.58	$968.58	$1,227.45
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $227.63 / $227.63 / $288.83	Professional	26	$227.63	$227.63	$288.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $740.95 / $740.95 / $938.70	Professional	TC	$740.95	$740.95	$938.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $117.78 / $212.52 / $315.74	Professional		$117.78	$212.52	$315.74
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.60 / $51.92 / $138.44	Professional	26	$40.60	$51.92	$138.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.59 / $160.61 / $428.28	Professional	TC	$125.59	$160.61	$428.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.60 / $151.00 / $330.32	Professional		$41.60	$151.00	$330.32
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $118.60 / $158.37 / $325.52	Professional		$118.60	$158.37	$325.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $37.02 / $67.73	Professional	26	$28.94	$37.02	$67.73
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $86.26 / $109.93 / $204.53	Professional	TC	$86.26	$109.93	$204.53
United Facility/Professional Professional Modifier Low / Median / High Price $127.33 / $159.16 / $242.21	Professional		$127.33	$159.16	$242.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.94 / $40.03 / $61.80	Professional	26	$30.94	$40.03	$61.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.57 / $119.82 / $180.45	Professional	TC	$95.57	$119.82	$180.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.92 / $135.22 / $192.40	Professional		$120.92	$135.22	$192.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $34.04 / $47.67	Professional	26	$29.54	$34.04	$47.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $91.38 / $101.17 / $145.44	Professional	TC	$91.38	$101.17	$145.44