Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.66 / $22.23 / $41.27	Facility	26	$20.66	$22.23	$41.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $140.37 / $353.98	Professional		$95.34	$140.37	$353.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $31.24 / $81.58	Professional	26	$22.23	$31.24	$81.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.56 / $90.27 / $179.94	Professional	TC	$70.56	$90.27	$179.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.88 / $163.01 / $192.13	Professional		$126.88	$163.01	$192.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.45 / $33.63 / $62.67	Professional	26	$24.45	$33.63	$62.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $95.70 / $134.01	Professional		$25.92	$95.70	$134.01
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $190.32 / $308.89	Professional		$150.00	$190.32	$308.89
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.25 / $30.82 / $31.34	Professional	26	$30.25	$30.82	$31.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.25 / $156.93 / $305.98	Professional		$97.25	$156.93	$305.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.60 / $34.97 / $65.79	Professional	26	$26.60	$34.97	$65.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $121.57 / $252.81	Professional	TC	$64.59	$121.57	$252.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $158.46 / $158.46	Facility	26	$100.00	$158.46	$158.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $898.89 / $898.89 / $1,186.05	Professional		$898.89	$898.89	$1,186.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $371.50 / $371.50 / $371.50	Professional	26	$371.50	$371.50	$371.50
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $695.99 / $695.99 / $929.03	Professional	TC	$695.99	$695.99	$929.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $242.91 / $340.08	Professional		$130.82	$242.91	$340.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $49.68 / $124.20	Professional	26	$38.81	$49.68	$124.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.34 / $239.21 / $637.88	Professional	TC	$199.34	$239.21	$637.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $160.50 / $348.52	Professional		$39.65	$160.50	$348.52
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.58 / $163.08 / $382.21	Professional		$97.58	$163.08	$382.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.60 / $33.24 / $63.20	Professional	26	$26.60	$33.24	$63.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $61.11 / $119.14 / $212.35	Professional	TC	$61.11	$119.14	$212.35
United Facility/Professional Professional Modifier Low / Median / High Price $97.85 / $148.83 / $239.71	Professional		$97.85	$148.83	$239.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.43 / $35.79 / $53.86	Professional	26	$27.43	$35.79	$53.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.06 / $111.72 / $179.28	Professional	TC	$62.06	$111.72	$179.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.05 / $130.82 / $186.39	Professional		$117.05	$130.82	$186.39
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.50 / $30.57 / $42.80	Professional	26	$26.50	$30.57	$42.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $90.55 / $100.26 / $144.18	Professional	TC	$90.55	$100.26	$144.18