Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.07 / $49.88 / $60.30	Facility	26	$43.07	$49.88	$60.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.19 / $194.13 / $709.48	Professional		$120.19	$194.13	$709.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $71.06 / $257.12	Professional	26	$34.07	$71.06	$257.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.64 / $120.11 / $452.37	Professional	TC	$75.64	$120.11	$452.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.74 / $110.93 / $180.33	Professional		$88.74	$110.93	$180.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.07 / $51.68 / $74.51	Professional	26	$43.07	$51.68	$74.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $98.48 / $165.16	Professional		$36.61	$98.48	$165.16
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $115.77 / $136.00 / $195.15	Professional		$115.77	$136.00	$195.15
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $331.68 / $417.52 / $420.16	Facility	26	$331.68	$417.52	$420.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $968.53 / $997.59 / $997.80	Professional		$968.53	$997.59	$997.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $279.39 / $279.39 / $368.63	Professional	26	$279.39	$279.39	$368.63
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $774.95 / $798.20 / $798.20	Professional	TC	$774.95	$798.20	$798.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $110.93 / $205.22	Professional		$47.49	$110.93	$205.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $101.20 / $203.65	Professional		$53.04	$101.20	$203.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.93 / $205.22 / $288.80	Professional		$110.93	$205.22	$288.80
United Facility/Professional Professional Modifier Low / Median / High Price $106.98 / $144.94 / $236.99	Professional		$106.98	$144.94	$236.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $45.77 / $78.53	Professional	26	$34.46	$45.77	$78.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.56 / $101.77 / $168.29	Professional	TC	$66.56	$101.77	$168.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $98.83 / $110.93 / $157.29	Professional		$98.83	$110.93	$157.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $43.07 / $59.72	Professional	26	$37.54	$43.07	$59.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.29 / $67.86 / $97.56	Professional	TC	$61.29	$67.86	$97.56