Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.57 / $25.51 / $40.10	Facility	26	$19.57	$25.51	$40.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $120.12 / $488.86	Professional		$66.37	$120.12	$488.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $31.37 / $126.44	Professional	26	$22.23	$31.37	$126.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.79 / $73.54 / $138.75	Professional	TC	$46.79	$73.54	$138.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $78.64 / $120.28	Professional		$63.88	$78.64	$120.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.37 / $28.64 / $55.85	Professional	26	$22.37	$28.64	$55.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.10 / $54.30 / $63.88	Professional	TC	$51.10	$54.30	$63.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.82 / $70.95 / $100.32	Professional		$24.82	$70.95	$100.32
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $82.57 / $106.40 / $164.69	Professional		$82.57	$106.40	$164.69
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $30.49 / $65.04	Professional	26	$28.35	$30.49	$65.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.39 / $108.10 / $209.93	Professional		$69.39	$108.10	$209.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.34 / $32.27 / $61.16	Professional	26	$24.34	$32.27	$61.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.25 / $74.88 / $153.58	Professional	TC	$44.25	$74.88	$153.58
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $147.82 / $147.82	Facility	26	$85.90	$147.82	$147.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $654.87 / $654.87 / $836.03	Professional		$654.87	$654.87	$836.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $217.94 / $217.94 / $242.48	Professional	26	$217.94	$217.94	$242.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $461.63 / $461.63 / $593.54	Professional	TC	$461.63	$461.63	$593.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $125.74 / $225.55	Professional		$47.51	$125.74	$225.55
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $43.67 / $116.44	Professional	26	$34.15	$43.67	$116.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.50 / $108.16 / $162.18	Professional	TC	$84.50	$108.16	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $80.89 / $158.91	Professional		$32.59	$80.89	$158.91
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.39 / $112.17 / $235.38	Professional		$69.39	$112.17	$235.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.34 / $31.07 / $57.54	Professional	26	$24.34	$31.07	$57.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $74.11 / $152.51	Professional	TC	$43.71	$74.11	$152.51
United Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $112.17 / $163.05	Professional		$71.81	$112.17	$163.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $33.77 / $51.02	Professional	26	$25.98	$33.77	$51.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.60 / $78.06 / $116.79	Professional	TC	$37.60	$78.06	$116.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.55 / $92.52 / $131.31	Professional		$82.55	$92.52	$131.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.84 / $28.64 / $40.10	Professional	26	$24.84	$28.64	$40.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $57.69 / $63.88 / $91.79	Professional	TC	$57.69	$63.88	$91.79