Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $19.05 / $33.88	Facility	26	$15.85	$19.05	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $57.54 / $234.42	Professional		$34.67	$57.54	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $31.62 / $112.20	Professional	26	$18.20	$31.62	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $20.89 / $48.98	Professional	TC	$14.79	$20.89	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $66.07	Professional		$30.20	$41.69	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.44 / $48.98	Professional	26	$17.78	$23.44	$48.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $23.44 / $27.54	Professional	TC	$10.72	$23.44	$27.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $34.67 / $50.12	Professional		$19.05	$34.67	$50.12
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $61.66 / $109.65	Professional		$39.81	$61.66	$109.65
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $45.71 / $45.71	Professional	26	$21.88	$45.71	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $26.92 / $38.02	Facility	26	$5.75	$26.92	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $114.82	Professional		$36.31	$51.29	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.30 / $50.12	Professional	26	$19.50	$26.30	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.55 / $63.10	Professional	TC	$16.60	$24.55	$63.10
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $501.19	Professional		$426.58	$426.58	$501.19
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $186.21 / $186.21	Professional	26	$151.36	$186.21	$186.21
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	TC	$380.19	$380.19	$380.19
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $19.05 / $33.88	Facility	26	$15.14	$19.05	$33.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.88 / $141.25	Professional		$36.31	$58.88	$141.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $31.62 / $77.62	Professional	26	$19.05	$31.62	$77.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $25.12 / $50.12	Professional	TC	$16.22	$25.12	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $32.36 / $39.81	Professional		$18.62	$32.36	$39.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $44.67 / $100.00	Professional		$21.38	$44.67	$100.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $26.92 / $38.02	Facility	26	$5.75	$26.92	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $117.49	Professional		$36.31	$50.12	$117.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $25.12 / $46.77	Professional	26	$19.50	$25.12	$46.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.39 / $61.66	Professional	TC	$16.22	$22.39	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $87.10	Professional		$38.02	$50.12	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.92 / $41.69	Professional	26	$20.42	$26.92	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.91 / $46.77	Professional	TC	$17.78	$22.91	$46.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $53.70	Professional		$43.65	$45.71	$53.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $24.55 / $29.51	Professional	26	$23.44	$24.55	$29.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $20.89 / $25.12	Professional	TC	$19.95	$20.89	$25.12