Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.95 / $19.37 / $30.39	Facility	26	$14.95	$19.37	$30.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.13 / $73.73 / $278.97	Professional		$35.13	$73.73	$278.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $20.07 / $71.16	Professional	26	$16.04	$20.07	$71.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $25.67 / $77.25	Professional	TC	$16.30	$25.67	$77.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $45.34 / $60.75	Professional		$32.71	$45.34	$60.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $22.78 / $43.45	Professional	26	$17.63	$22.78	$43.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.69 / $19.55 / $32.42	Professional	TC	$13.69	$19.55	$32.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $37.28 / $49.48	Professional		$19.10	$37.28	$49.48
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $61.00 / $97.00	Professional		$43.92	$61.00	$97.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $23.52 / $35.61	Professional	26	$22.05	$23.52	$35.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $68.89 / $150.47	Professional		$38.84	$68.89	$150.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $23.22 / $42.73	Professional	26	$16.55	$23.22	$42.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $34.42 / $112.51	Professional	TC	$19.20	$34.42	$112.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $55.69 / $115.19 / $115.19	Facility	26	$55.69	$115.19	$115.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $575.66 / $592.92 / $592.92	Professional		$575.66	$592.92	$592.92
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $232.81 / $232.81 / $232.81	Professional	26	$232.81	$232.81	$232.81
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $385.57 / $398.91 / $409.84	Professional	TC	$385.57	$398.91	$409.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $67.73 / $149.44	Professional		$39.01	$67.73	$149.44
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 $30.36 / $38.82 / $103.52	Professional	TC	$30.36	$38.82	$103.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.53 / $34.40 / $81.78	Professional		$17.53	$34.40	$81.78
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $73.12 / $146.01	Professional		$39.72	$73.12	$146.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $22.74 / $39.81	Professional	26	$16.23	$22.74	$39.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $30.50 / $118.34	Professional	TC	$18.79	$30.50	$118.34
United Facility/Professional Professional Modifier Low / Median / High Price $41.83 / $57.17 / $108.70	Professional		$41.83	$57.17	$108.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.95 / $24.31 / $38.34	Professional	26	$18.95	$24.31	$38.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $29.14 / $87.13	Professional	TC	$19.48	$29.14	$87.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $46.73 / $65.88	Professional		$41.41	$46.73	$65.88
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 $22.09 / $24.45 / $35.13	Professional	TC	$22.09	$24.45	$35.13