Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.34 / $39.25 / $61.25	Facility	26	$30.34	$39.25	$61.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.32 / $144.69 / $547.98	Professional		$94.32	$144.69	$547.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $45.13 / $178.04	Professional	26	$33.10	$45.13	$178.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.34 / $84.67 / $163.66	Professional	TC	$60.34	$84.67	$163.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.49 / $130.00 / $206.21	Professional		$96.49	$130.00	$206.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $45.89 / $84.92	Professional	26	$35.07	$45.89	$84.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.84 / $77.08 / $142.68	Professional	TC	$55.84	$77.08	$142.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.46 / $95.56 / $138.44	Professional		$38.46	$95.56	$138.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $117.74 / $170.07 / $243.01	Professional		$117.74	$170.07	$243.01
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $44.40 / $47.69 / $101.27	Professional	26	$44.40	$47.69	$101.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	26	$53.96	$53.96	$53.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.24 / $144.49 / $271.82	Professional		$108.24	$144.49	$271.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $50.55 / $94.67	Professional	26	$38.58	$50.55	$94.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.37 / $92.01 / $177.97	Professional	TC	$69.37	$92.01	$177.97
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $111.76 / $232.47 / $232.47	Facility	26	$111.76	$232.47	$232.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $872.98 / $872.98 / $1,120.05	Professional		$872.98	$872.98	$1,120.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $298.50 / $298.50 / $379.35	Professional	26	$298.50	$298.50	$379.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $574.48 / $574.48 / $740.70	Professional	TC	$574.48	$574.48	$740.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $92.86 / $192.54 / $283.73	Professional		$92.86	$192.54	$283.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $68.42 / $182.44	Professional	26	$53.50	$68.42	$182.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.02 / $126.63 / $337.68	Professional	TC	$99.02	$126.63	$337.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $91.74 / $215.31	Professional		$45.62	$91.74	$215.31
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	26	$53.96	$53.96	$53.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.07 / $149.62 / $311.85	Professional		$109.07	$149.62	$311.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.76 / $48.62 / $89.95	Professional	26	$38.76	$48.62	$89.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $69.37 / $89.98 / $172.16	Professional	TC	$69.37	$89.98	$172.16
United Facility/Professional Professional Modifier Low / Median / High Price $116.08 / $151.50 / $227.52	Professional		$116.08	$151.50	$227.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $51.28 / $81.05	Professional	26	$40.54	$51.28	$81.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.97 / $97.36 / $146.66	Professional	TC	$76.97	$97.36	$146.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $110.98 / $124.62 / $176.61	Professional		$110.98	$124.62	$176.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.93 / $44.85 / $62.79	Professional	26	$38.93	$44.85	$62.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $72.05 / $79.77 / $114.66	Professional	TC	$72.05	$79.77	$114.66