Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.17 / $33.85 / $49.64	Facility	26	$26.17	$33.85	$49.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.88 / $113.46 / $441.09	Professional		$76.88	$113.46	$441.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.56 / $39.11 / $192.00	Professional	26	$28.56	$39.11	$192.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.69 / $58.48 / $118.51	Professional	TC	$45.69	$58.48	$118.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $105.85 / $158.38	Professional		$77.81	$105.85	$158.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.84 / $38.19 / $74.45	Professional	26	$29.84	$38.19	$74.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.86 / $60.49 / $111.98	Professional	TC	$43.86	$60.49	$111.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $77.84 / $111.50	Professional		$32.74	$77.84	$111.50
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $90.77 / $117.39 / $190.00	Professional		$90.77	$117.39	$190.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $41.14 / $75.28	Professional	26	$37.79	$41.14	$75.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.73 / $111.44 / $214.91	Professional		$85.73	$111.44	$214.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $43.35 / $79.20	Professional	26	$33.22	$43.35	$79.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.20 / $69.47 / $135.34	Professional	TC	$51.20	$69.47	$135.34
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.69 / $198.74 / $198.74	Facility	26	$95.69	$198.74	$198.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $171.39 / $708.49 / $902.10	Professional		$171.39	$708.49	$902.10
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $257.68 / $257.68 / $321.00	Professional	26	$257.68	$257.68	$321.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $450.80 / $450.80 / $581.10	Professional	TC	$450.80	$450.80	$581.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $147.69 / $223.83	Professional		$71.81	$147.69	$223.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.54 / $58.23 / $155.28	Professional	26	$45.54	$58.23	$155.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.78 / $99.47 / $265.24	Professional	TC	$77.78	$99.47	$265.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.19 / $74.86 / $176.49	Professional		$38.19	$74.86	$176.49
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.90 / $116.76 / $243.97	Professional		$87.90	$116.76	$243.97
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $41.53 / $78.27	Professional	26	$33.22	$41.53	$78.27
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $53.26 / $68.53 / $130.69	Professional	TC	$53.26	$68.53	$130.69
United Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $117.86 / $179.34	Professional		$92.10	$117.86	$179.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $44.61 / $68.41	Professional	26	$34.65	$44.61	$68.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.45 / $75.31 / $110.70	Professional	TC	$57.45	$75.31	$110.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.73 / $100.85 / $142.90	Professional		$89.73	$100.85	$142.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $38.19 / $53.47	Professional	26	$33.13	$38.19	$53.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.59 / $62.66 / $90.09	Professional	TC	$56.59	$62.66	$90.09