Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $23.99 / $123.03	Facility	26	$18.62	$23.99	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $177.83	Professional		$40.74	$58.88	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $97.72	Professional	26	$22.91	$38.02	$97.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $47.86 / $229.09	Professional	52	$23.99	$47.86	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $69.18	Professional	TC	$17.38	$25.70	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $42.66 / $75.86	Professional		$34.67	$42.66	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $26.92 / $46.77	Professional	26	$21.38	$26.92	$46.77
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.77 / $10.96 / $21.38	Professional	52	$9.77	$10.96	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.38 / $32.36	Professional	TC	$15.49	$21.38	$32.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $40.74 / $61.66	Professional		$23.44	$40.74	$61.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $95.50	Professional		$47.86	$69.18	$95.50
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $30.20 / $30.20	Professional	26	$26.92	$30.20	$30.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $32.36 / $46.77	Facility	26	$6.92	$32.36	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $112.20	Professional		$42.66	$60.26	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $63.10	Professional	26	$23.99	$33.11	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $53.70	Professional	TC	$19.05	$28.18	$53.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $331.13 / $436.52	Professional		$58.88	$331.13	$436.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $229.09 / $229.09	Professional	26	$181.97	$229.09	$229.09
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $204.17 / $204.17	Professional	TC	$151.36	$204.17	$204.17
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $23.99 / $40.74	Facility	26	$18.62	$23.99	$40.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $147.91	Professional		$40.74	$61.66	$147.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $89.13	Professional	26	$22.91	$36.31	$89.13
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $25.12 / $53.70 / $229.09	Professional	52	$25.12	$53.70	$229.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.18 / $61.66	Professional	TC	$18.20	$28.18	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $32.36 / $44.67	Professional		$22.91	$32.36	$44.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $47.86 / $93.33	Professional		$23.44	$47.86	$93.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $32.36 / $46.77	Facility	26	$6.92	$32.36	$46.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $123.03	Professional		$42.66	$58.88	$123.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $53.70	Professional	26	$23.99	$30.90	$53.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $44.67	Professional	TC	$19.05	$25.70	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $93.33	Professional		$45.71	$61.66	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $50.12	Professional	26	$24.55	$33.88	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.54 / $41.69	Professional	TC	$20.89	$27.54	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $61.66	Professional		$48.98	$51.29	$61.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.18 / $33.88	Professional	26	$26.92	$28.18	$33.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $23.44 / $27.54	Professional	TC	$22.39	$23.44	$27.54