Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $19.05 / $47.86	Facility	26	$14.79	$19.05	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $69.18 / $204.17	Professional		$31.62	$69.18	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $41.69 / $123.03	Professional	26	$16.98	$41.69	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $70.79 / $346.74	Professional	50	$36.31	$70.79	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $26.92 / $70.79	Professional	TC	$8.91	$26.92	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $97.72	Professional		$41.69	$51.29	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $61.66	Professional	26	$24.55	$30.90	$61.66
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	50	$79.43	$79.43	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $41.69	Professional	TC	$21.38	$28.84	$41.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $50.12 / $70.79	Professional		$26.92	$50.12	$70.79
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $107.15	Professional		$56.23	$81.28	$107.15
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $24.55 / $31.62	Professional	26	$24.55	$24.55	$31.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $53.70	Facility	26	$7.94	$37.15	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $102.33	Professional		$29.51	$51.29	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $27.54 / $53.70	Professional	26	$19.50	$27.54	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $22.91 / $51.29	Professional	TC	$9.33	$22.91	$51.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	26	$162.18	$162.18	$162.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $363.08 / $537.03	Professional		$72.44	$363.08	$537.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $263.03 / $263.03	Professional	26	$194.98	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $269.15 / $269.15	Professional	TC	$213.80	$269.15	$269.15
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $18.62 / $42.66	Facility	26	$14.79	$18.62	$42.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $69.18 / $162.18	Professional		$33.11	$69.18	$162.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $38.02 / $95.50	Professional	26	$17.38	$38.02	$95.50
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $72.44 / $549.54	Professional	50	$35.48	$72.44	$549.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $31.62 / $69.18	Professional	TC	$10.47	$31.62	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $32.36 / $33.11	Professional		$8.91	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $57.54 / $112.20	Professional		$30.20	$57.54	$112.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $53.70	Facility	26	$7.94	$37.15	$53.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $53.70 / $112.20	Professional		$29.51	$53.70	$112.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $47.86	Professional	26	$19.50	$26.92	$47.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $22.91 / $48.98	Professional	TC	$8.91	$22.91	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $87.10	Professional		$33.88	$50.12	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.12 / $39.81	Professional	26	$20.42	$25.12	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $25.12 / $44.67	Professional	TC	$10.47	$25.12	$44.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $77.62	Professional		$61.66	$64.57	$77.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $32.36 / $38.90	Professional	26	$31.62	$32.36	$38.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $31.62 / $38.02	Professional	TC	$30.20	$31.62	$38.02