Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.39 / $19.94 / $31.19	Facility	26	$15.39	$19.94	$31.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.51 / $45.71 / $232.00	Professional		$31.51	$45.71	$232.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.79 / $22.61 / $96.85	Professional	26	$16.79	$22.61	$96.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $20.02 / $38.65	Professional	TC	$14.51	$20.02	$38.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.99 / $45.37 / $76.20	Professional		$32.99	$45.37	$76.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $26.40 / $43.43	Professional	26	$17.82	$26.40	$43.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.62 / $18.35 / $33.97	Professional	TC	$14.62	$18.35	$33.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $35.94 / $49.95	Professional		$19.10	$35.94	$49.95
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $41.22 / $53.60 / $109.40	Professional		$41.22	$53.60	$109.40
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $22.06 / $24.19 / $45.79	Professional	26	$22.06	$24.19	$45.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $48.40 / $106.19	Professional		$35.24	$48.40	$106.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $25.39 / $46.83	Professional	26	$19.12	$25.39	$46.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.80 / $22.33 / $58.02	Professional	TC	$15.80	$22.33	$58.02
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $115.95 / $115.95	Facility	26	$55.98	$115.95	$115.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $426.95 / $495.56 / $495.56	Professional		$426.95	$495.56	$495.56
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.44 / $151.44 / $186.98	Professional	26	$151.44	$151.44	$186.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $367.63 / $378.66 / $378.66	Professional	TC	$367.63	$378.66	$378.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $66.52 / $137.80	Professional		$35.02	$66.52	$137.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $33.96 / $90.56	Professional	26	$26.56	$33.96	$90.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $30.08 / $80.20	Professional	TC	$23.52	$30.08	$80.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.81 / $29.67 / $74.95	Professional		$14.81	$29.67	$74.95
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.52 / $49.83 / $116.58	Professional		$35.52	$49.83	$116.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $24.49 / $45.10	Professional	26	$19.39	$24.49	$45.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.21 / $49.77	Professional	TC	$15.49	$21.21	$49.77
United Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $50.02 / $80.98	Professional		$36.99	$50.02	$80.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $26.69 / $40.24	Professional	26	$20.39	$26.69	$40.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $23.12 / $47.10	Professional	TC	$16.78	$23.12	$47.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $41.23 / $58.02	Professional		$36.44	$41.23	$58.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $22.28 / $31.19	Professional	26	$19.32	$22.28	$31.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $18.95 / $27.20	Professional	TC	$17.11	$18.95	$27.20