Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $28.84 / $33.88	Facility	26	$26.92	$28.84	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $169.82 / $457.09	Professional		$85.11	$169.82	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $61.66 / $208.93	Professional	26	$32.36	$61.66	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $69.18 / $158.49	Professional	TC	$47.86	$69.18	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $147.91	Professional		$74.13	$104.71	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $39.81 / $74.13	Professional	26	$31.62	$39.81	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $63.10 / $91.20	Professional	TC	$46.77	$63.10	$91.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $83.18 / $112.20	Professional		$32.36	$83.18	$112.20
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $190.55	Professional		$95.50	$123.03	$190.55
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $75.86 / $75.86	Professional	26	$38.02	$75.86	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $66.07	Facility	26	$9.77	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $223.87	Professional		$87.10	$117.49	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $87.10	Professional	26	$33.11	$44.67	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $144.54	Professional	TC	$53.70	$72.44	$144.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $707.95 / $912.01	Professional		$117.49	$707.95	$912.01
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $257.04 / $323.59 / $323.59	Professional	26	$257.04	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $575.44 / $575.44	Professional	TC	$446.68	$575.44	$575.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $33.11 / $50.12	Facility	26	$26.92	$33.11	$50.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $144.54 / $331.13	Professional		$85.11	$144.54	$331.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $52.48 / $144.54	Professional	26	$31.62	$52.48	$144.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $79.43 / $151.36	Professional	TC	$51.29	$79.43	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $37.15 / $97.72	Professional		$32.36	$37.15	$97.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $107.15 / $257.04	Professional		$42.66	$107.15	$257.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $66.07	Facility	26	$9.77	$45.71	$66.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $234.42	Professional		$89.13	$114.82	$234.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $42.66 / $79.43	Professional	26	$33.11	$42.66	$79.43
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $69.18 / $134.90	Professional	TC	$53.70	$69.18	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $181.97	Professional		$93.33	$117.49	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.67 / $69.18	Professional	26	$34.67	$44.67	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $72.44 / $112.20	Professional	TC	$58.88	$72.44	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $131.83	Professional		$107.15	$112.20	$131.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $50.12	Professional	26	$39.81	$41.69	$50.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $70.79 / $83.18	Professional	TC	$67.61	$70.79	$83.18