Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.63 / $32.00 / $49.47	Facility	26	$24.63	$32.00	$49.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.42 / $130.06 / $400.90	Professional		$87.42	$130.06	$400.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $36.29 / $59.85	Professional	26	$26.90	$36.29	$59.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.52 / $86.23 / $151.87	Professional	TC	$60.52	$86.23	$151.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $99.16 / $151.66	Professional		$90.20	$99.16	$151.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $38.85 / $70.73	Professional	26	$29.02	$38.85	$70.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.27 / $64.31 / $64.31	Professional	TC	$56.27	$64.31	$64.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.30 / $92.75 / $142.06	Professional		$31.30	$92.75	$142.06
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $97.81 / $154.00 / $220.77	Professional		$97.81	$154.00	$220.77
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $38.71 / $40.72	Professional	26	$35.90	$38.71	$40.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.13 / $141.06 / $256.07	Professional		$98.13	$141.06	$256.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $43.12 / $78.13	Professional	26	$30.83	$43.12	$78.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.89 / $99.65 / $179.15	Professional	TC	$69.89	$99.65	$179.15
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $187.10 / $187.10	Facility	26	$90.38	$187.10	$187.10
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $810.58 / $810.58 / $1,053.68	Professional		$810.58	$810.58	$1,053.68
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $242.65 / $242.65 / $307.35	Professional	26	$242.65	$242.65	$307.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $567.92 / $567.92 / $746.33	Professional	TC	$567.92	$567.92	$746.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.98 / $175.50 / $352.95	Professional		$63.98	$175.50	$352.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $60.85 / $147.52	Professional	26	$47.94	$60.85	$147.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.59 / $140.37 / $340.28	Professional	TC	$110.59	$140.37	$340.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.63 / $104.78 / $204.54	Professional		$42.63	$104.78	$204.54
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $156.22 / $328.60	Professional		$101.09	$156.22	$328.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.20 / $41.58 / $76.84	Professional	26	$31.20	$41.58	$76.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $70.22 / $97.26 / $173.54	Professional	TC	$70.22	$97.26	$173.54
United Facility/Professional Professional Modifier Low / Median / High Price $111.73 / $150.06 / $220.61	Professional		$111.73	$150.06	$220.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.49 / $45.02 / $71.16	Professional	26	$33.49	$45.02	$71.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.90 / $104.01 / $158.88	Professional	TC	$75.90	$104.01	$158.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $116.66 / $165.58	Professional		$104.08	$116.66	$165.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $36.27 / $50.04	Professional	26	$31.48	$36.27	$50.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $72.59 / $80.39 / $115.53	Professional	TC	$72.59	$80.39	$115.53