Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.75 / $30.87 / $46.96	Facility	26	$23.75	$30.87	$46.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $86.30 / $272.44	Professional		$58.23	$86.30	$272.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.74 / $35.35 / $105.55	Professional	26	$25.74	$35.35	$105.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.83 / $45.06 / $85.82	Professional	TC	$31.83	$45.06	$85.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.62 / $83.64 / $141.36	Professional		$60.62	$83.64	$141.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $34.38 / $67.03	Professional	26	$27.50	$34.38	$67.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.32 / $40.64 / $81.58	Professional	TC	$35.32	$40.64	$81.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $62.16 / $86.99	Professional		$29.46	$62.16	$86.99
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.30 / $103.88 / $157.78	Professional		$72.30	$103.88	$157.78
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $37.35 / $63.63	Professional	26	$34.03	$37.35	$63.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.93 / $92.51 / $172.39	Professional		$67.93	$92.51	$172.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $39.22 / $72.34	Professional	26	$29.92	$39.22	$72.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.64 / $52.85 / $100.36	Professional	TC	$38.64	$52.85	$100.36
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $178.60 / $178.60	Facility	26	$100.00	$178.60	$178.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $555.44 / $579.47 / $712.88	Professional		$555.44	$579.47	$712.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.13 / $269.13 / $288.98	Professional	26	$269.13	$269.13	$288.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $351.46 / $351.46 / $423.83	Professional	TC	$351.46	$351.46	$423.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.59 / $124.70 / $200.85	Professional		$55.59	$124.70	$200.85
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.97 / $52.40 / $139.72	Professional	26	$40.97	$52.40	$139.72
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.43 / $72.30 / $192.80	Professional	TC	$55.43	$72.30	$192.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.23 / $59.34 / $139.84	Professional		$31.23	$59.34	$139.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $94.53 / $190.58	Professional		$69.00	$94.53	$190.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $37.69 / $70.41	Professional	26	$29.92	$37.69	$70.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $38.64 / $49.85 / $95.56	Professional	TC	$38.64	$49.85	$95.56
United Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $94.74 / $141.47	Professional		$70.73	$94.74	$141.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $40.44 / $61.80	Professional	26	$31.48	$40.44	$61.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $52.98 / $78.87	Professional	TC	$39.92	$52.98	$78.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $79.91 / $112.91	Professional		$70.95	$79.91	$112.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.81 / $34.38 / $48.13	Professional	26	$29.81	$34.38	$48.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.14 / $45.54 / $65.41	Professional	TC	$41.14	$45.54	$65.41