Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.45 / $15.08 / $23.31	Facility	26	$11.45	$15.08	$23.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.26 / $95.09 / $166.58	Professional		$67.26	$95.09	$166.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.55 / $17.36 / $46.64	Professional	26	$12.55	$17.36	$46.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.81 / $75.11 / $134.30	Professional	TC	$55.81	$75.11	$134.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.73 / $75.16 / $76.16	Professional		$62.73	$75.16	$76.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $18.89 / $33.47	Professional	26	$13.49	$18.89	$33.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.55 / $70.67 / $99.94	Professional		$14.55	$70.67	$99.94
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $128.52 / $174.74	Professional		$84.00	$128.52	$174.74
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $17.00 / $18.18 / $18.55	Professional	26	$17.00	$18.18	$18.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.86 / $102.59 / $192.24	Professional		$70.86	$102.59	$192.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $19.55 / $35.75	Professional	26	$14.59	$19.55	$35.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.27 / $81.80 / $159.51	Professional	TC	$57.27	$81.80	$159.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $87.12 / $87.12	Facility	26	$42.12	$87.12	$87.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $664.33 / $664.33 / $819.75	Professional		$664.33	$664.33	$819.75
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.72 / $113.72 / $148.19	Professional	26	$113.72	$113.72	$148.19
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $550.61 / $550.61 / $671.63	Professional	TC	$550.61	$550.61	$671.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $141.19 / $234.52	Professional		$49.69	$141.19	$234.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $26.21 / $69.88	Professional	26	$22.71	$26.21	$69.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.66 / $114.99 / $306.64	Professional	TC	$99.66	$114.99	$306.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $80.39 / $179.40	Professional		$19.14	$80.39	$179.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.12 / $116.11 / $245.78	Professional		$76.12	$116.11	$245.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $19.25 / $34.72	Professional	26	$14.76	$19.25	$34.72
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $57.52 / $82.67 / $156.40	Professional	TC	$57.52	$82.67	$156.40
United Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $95.51 / $153.62	Professional		$67.34	$95.51	$153.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $18.17 / $30.05	Professional	26	$15.30	$18.17	$30.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $77.70 / $118.00	Professional	TC	$48.98	$77.70	$118.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $89.61 / $127.75	Professional		$80.34	$89.61	$127.75
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.91 / $17.17 / $23.58	Professional	26	$14.91	$17.17	$23.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $65.43 / $72.44 / $104.17	Professional	TC	$65.43	$72.44	$104.17