Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.26 / $19.66 / $37.83	Facility	26	$18.26	$19.66	$37.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $102.74 / $186.81	Professional		$72.59	$102.74	$186.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $26.60 / $54.03	Professional	26	$19.66	$26.60	$54.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.90 / $71.18 / $125.51	Professional	TC	$51.90	$71.18	$125.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.55 / $83.24 / $107.72	Professional		$68.55	$83.24	$107.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $28.26 / $49.66	Professional	26	$21.08	$28.26	$49.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.64 / $49.64 / $49.64	Professional	TC	$49.64	$49.64	$49.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.19 / $73.06 / $108.44	Professional		$23.19	$73.06	$108.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $107.72 / $174.32	Professional		$88.14	$107.72	$174.32
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.75 / $28.66 / $68.95	Professional	26	$26.75	$28.66	$68.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.08 / $108.90 / $203.00	Professional		$81.08	$108.90	$203.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.97 / $30.61 / $57.93	Professional	26	$22.97	$30.61	$57.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.76 / $79.28 / $147.18	Professional	TC	$57.76	$79.28	$147.18
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $67.03 / $139.84 / $139.84	Facility	26	$67.03	$139.84	$139.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $674.54 / $674.54 / $888.15	Professional		$674.54	$674.54	$888.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $180.38 / $180.38 / $229.58	Professional	26	$180.38	$180.38	$229.58
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $494.15 / $494.15 / $658.65	Professional	TC	$494.15	$494.15	$658.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.93 / $153.81 / $258.30	Professional		$97.93	$153.81	$258.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $41.24 / $109.96	Professional	26	$32.25	$41.24	$109.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.02 / $112.56 / $300.16	Professional	TC	$88.02	$112.56	$300.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $105.78 / $214.34	Professional		$31.97	$105.78	$214.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $82.50 / $111.78 / $231.56	Professional		$82.50	$111.78	$231.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $29.46 / $53.69	Professional	26	$23.25	$29.46	$53.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $57.96 / $76.59 / $138.13	Professional	TC	$57.96	$76.59	$138.13
United Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $114.29 / $166.96	Professional		$87.08	$114.29	$166.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $31.84 / $49.07	Professional	26	$23.15	$31.84	$49.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.76 / $82.52 / $124.70	Professional	TC	$62.76	$82.52	$124.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.51 / $97.93 / $139.21	Professional		$87.51	$97.93	$139.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $27.02 / $37.83	Professional	26	$23.46	$27.02	$37.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $64.04 / $70.91 / $101.91	Professional	TC	$64.04	$70.91	$101.91