Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.73 / $19.10 / $43.64	Facility	26	$14.73	$19.10	$43.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $46.91 / $170.00	Professional		$28.28	$46.91	$170.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $20.69 / $84.96	Professional	26	$15.86	$20.69	$84.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $346.50 / $346.50 / $346.50	Professional	50	$346.50	$346.50	$346.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $24.44 / $54.47	Professional	TC	$9.18	$24.44	$54.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $51.17 / $78.26	Professional		$42.14	$51.17	$78.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $31.17 / $60.78	Professional	26	$24.28	$31.17	$60.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $23.23 / $29.04	Professional	TC	$23.23	$23.23	$29.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.73 / $34.36 / $54.18	Professional		$26.73	$34.36	$54.18
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $52.20 / $70.06 / $103.17	Professional		$52.20	$70.06	$103.17
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $29.96 / $31.67	Professional	26	$24.33	$29.96	$31.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.68 / $51.61 / $94.09	Professional		$29.68	$51.61	$94.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $27.57 / $48.72	Professional	26	$19.66	$27.57	$48.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.36 / $24.49 / $48.36	Professional	TC	$9.36	$24.49	$48.36
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $77.38 / $160.55 / $160.55	Facility	26	$77.38	$160.55	$160.55
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $359.16 / $359.16 / $534.98	Professional		$359.16	$359.16	$534.98
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $193.46 / $197.46 / $265.05	Professional	26	$193.46	$197.46	$265.05
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $214.27 / $214.27 / $269.93	Professional	TC	$214.27	$214.27	$269.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $81.16 / $148.75	Professional		$33.79	$81.16	$148.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.18 / $47.55 / $126.80	Professional	26	$37.18	$47.55	$126.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.04 / $46.10 / $122.92	Professional	TC	$36.04	$46.10	$122.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.95 / $48.63 / $100.38	Professional		$30.95	$48.63	$100.38
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.66 / $53.99 / $109.62	Professional		$29.66	$53.99	$109.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $26.88 / $44.57	Professional	26	$19.60	$26.88	$44.57
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $9.21 / $24.51 / $41.92	Professional	TC	$9.21	$24.51	$41.92
United Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $51.31 / $87.15	Professional		$32.97	$51.31	$87.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $24.90 / $38.10	Professional	26	$19.82	$24.90	$38.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.34 / $26.56 / $45.48	Professional	TC	$10.34	$26.56	$45.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.28 / $60.20 / $84.70	Professional		$53.28	$60.20	$84.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.05 / $31.17 / $43.64	Professional	26	$27.05	$31.17	$43.64
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $29.04 / $41.72	Professional	TC	$26.23	$29.04	$41.72