Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.00 / $19.05	Facility	26	$8.51	$10.00	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $128.82	Professional		$30.20	$45.71	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.14 / $41.69	Professional	26	$10.00	$15.14	$41.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.77 / $144.54 / $144.54	Professional	52	$46.77	$144.54	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $56.23	Professional	TC	$20.89	$28.18	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $63.10	Professional		$32.36	$38.90	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.79 / $20.89	Professional	26	$10.47	$14.79	$20.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $44.67	Professional	TC	$23.44	$33.11	$44.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $35.48 / $46.77	Professional		$10.23	$35.48	$46.77
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $63.10	Professional		$39.81	$51.29	$63.10
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.59 / $13.49	Professional	26	$12.30	$12.59	$13.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.16 / $14.79 / $21.38	Facility	26	$3.16	$14.79	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $85.11	Professional		$31.62	$45.71	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $29.51	Professional	26	$10.96	$15.49	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $60.26	Professional	TC	$19.95	$30.90	$60.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $380.19 / $380.19	Professional		$288.40	$380.19	$380.19
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $107.15 / $107.15	Professional	26	$83.18	$107.15	$107.15
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $275.42 / $275.42	Professional	TC	$208.93	$275.42	$275.42
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.47 / $19.05	Facility	26	$7.94	$10.47	$19.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $114.82	Professional		$33.11	$53.70	$114.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $37.15	Professional	26	$10.00	$16.98	$37.15
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $46.77 / $144.54 / $144.54	Professional	52	$46.77	$144.54	$144.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $67.61	Professional	TC	$20.89	$33.88	$67.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $32.36 / $36.31	Professional		$10.96	$32.36	$36.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $47.86 / $91.20	Professional		$14.13	$47.86	$91.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.16 / $14.79 / $21.38	Facility	26	$3.16	$14.79	$21.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $93.33	Professional		$31.62	$45.71	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.45 / $26.30	Professional	26	$10.96	$14.45	$26.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $52.48	Professional	TC	$19.05	$29.51	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $69.18	Professional		$33.88	$41.69	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $13.80 / $22.91	Professional	26	$11.22	$13.80	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $45.71	Professional	TC	$20.42	$28.18	$45.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $46.77 / $54.95	Professional		$44.67	$46.77	$54.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $13.18 / $15.85	Professional	26	$12.59	$13.18	$15.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $33.11 / $39.81	Professional	TC	$31.62	$33.11	$39.81