Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $436.52 / $1,122.02	Facility		$43.65	$436.52	$1,122.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $9.33 / $19.50	Facility	26	$8.51	$9.33	$19.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $81.28	Professional		$25.70	$37.15	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $58.88	Professional	26	$10.00	$17.38	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $44.67	Professional	TC	$16.98	$21.88	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $30.20 / $45.71	Professional		$26.92	$30.20	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.13 / $23.44	Professional	26	$9.77	$14.13	$23.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $36.31 / $81.28	Facility		$14.45	$36.31	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $29.51 / $38.02	Professional		$10.96	$29.51	$38.02
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $190.55 / $602.56	Facility		$44.67	$190.55	$602.56
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $64.57	Professional		$32.36	$48.98	$64.57
Christus Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $13.49 / $38.90	Facility		$13.49	$13.49	$38.90
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.45 / $14.45	Professional	26	$12.59	$14.45	$14.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $97.72 / $109.65	Facility		$40.74	$97.72	$109.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.31 / $15.49 / $21.88	Facility	26	$3.31	$15.49	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $72.44	Professional		$28.18	$38.90	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.85 / $28.84	Professional	26	$11.22	$15.85	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $44.67	Professional	TC	$15.85	$22.91	$44.67
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $537.03 / $537.03	Facility		$251.19	$537.03	$537.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $288.40 / $323.59	Professional		$44.67	$288.40	$323.59
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $204.17	Professional	26	$107.15	$107.15	$204.17
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	TC	$229.09	$229.09	$229.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $47.86 / $120.23	Facility		$31.62	$47.86	$120.23
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.72 / $19.05	Facility	26	$8.51	$10.72	$19.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $45.71 / $83.18	Professional		$28.84	$45.71	$83.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $17.38 / $51.29	Professional	26	$10.72	$17.38	$51.29
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.84 / $50.12	Professional	TC	$17.78	$28.84	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $32.36 / $33.11	Professional		$11.48	$32.36	$33.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $11,220.18 / $12,882.50	Facility		$3,630.78	$11,220.18	$12,882.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $37.15 / $83.18	Professional		$14.45	$37.15	$83.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $46.77 / $79.43	Facility		$32.36	$46.77	$79.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.31 / $15.49 / $21.88	Facility	26	$3.31	$15.49	$21.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $77.62	Professional		$28.18	$38.90	$77.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.79 / $27.54	Professional	26	$11.22	$14.79	$27.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $41.69	Professional	TC	$15.85	$21.88	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.02 / $56.23	Professional		$29.51	$38.02	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.49 / $23.44	Professional	26	$12.02	$15.49	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.39 / $33.88	Professional	TC	$16.60	$22.39	$33.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $40.74 / $47.86	Professional		$38.90	$40.74	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.13 / $16.60	Professional	26	$13.49	$14.13	$16.60
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $26.92 / $31.62	Professional	TC	$25.12	$26.92	$31.62