Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.48 / $24.10 / $122.57	Facility	26	$18.48	$24.10	$122.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $53.76 / $147.63	Professional		$38.97	$53.76	$147.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.19 / $27.68 / $75.25	Professional	26	$20.19	$27.68	$75.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.40 / $69.65 / $285.00	Professional	52	$33.40	$69.65	$285.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.19 / $23.57 / $61.80	Professional	TC	$16.19	$23.57	$61.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $41.24 / $76.17	Professional		$39.24	$41.24	$76.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $29.72 / $52.73	Professional	26	$21.51	$29.72	$52.73
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.81 / $10.17 / $12.05	Professional	52	$9.81	$10.17	$12.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $22.01 / $46.90	Professional	TC	$15.41	$22.01	$46.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $43.39 / $70.45	Professional		$23.62	$43.39	$70.45
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.54 / $67.00 / $87.31	Professional		$48.54	$67.00	$87.31
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.77 / $28.35 / $29.92	Professional	26	$26.77	$28.35	$29.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $58.92 / $105.32	Professional		$41.39	$58.92	$105.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.98 / $32.61 / $58.27	Professional	26	$22.98	$32.61	$58.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $27.13 / $48.41	Professional	TC	$18.88	$27.13	$48.41
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $67.28 / $139.60 / $139.60	Facility	26	$67.28	$139.60	$139.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $334.42 / $334.42 / $432.98	Professional		$334.42	$334.42	$432.98
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $182.49 / $182.49 / $229.28	Professional	26	$182.49	$182.49	$229.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.88 / $151.88 / $203.70	Professional	TC	$151.88	$151.88	$203.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $76.50 / $179.10	Professional		$41.24	$76.50	$179.10
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $45.36 / $109.96	Professional	26	$35.74	$45.36	$109.96
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $52.26 / $87.88 / $143.28	Professional	52	$52.26	$87.88	$143.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.28 / $38.43 / $93.16	Professional	TC	$30.28	$38.43	$93.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.74 / $41.95 / $89.01	Professional		$24.74	$41.95	$89.01
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.83 / $64.68 / $137.46	Professional		$42.83	$64.68	$137.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $31.35 / $57.39	Professional	26	$23.74	$31.35	$57.39
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $26.35 / $46.38	Professional	TC	$18.97	$26.35	$46.38
United Facility/Professional Professional Modifier Low / Median / High Price $45.42 / $61.53 / $95.00	Professional		$45.42	$61.53	$95.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.54 / $33.75 / $51.94	Professional	26	$24.54	$33.75	$51.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $27.78 / $42.94	Professional	TC	$21.10	$27.78	$42.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $49.05 / $68.97	Professional		$43.34	$49.05	$68.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $27.04 / $37.31	Professional	26	$23.46	$27.04	$37.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $22.01 / $31.66	Professional	TC	$19.88	$22.01	$31.66