Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $10.92 / $18.36	Facility	26	$8.36	$10.92	$18.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $39.61 / $90.69	Professional		$30.55	$39.61	$90.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $12.65 / $25.72	Professional	26	$9.52	$12.65	$25.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.70 / $18.95 / $29.59	Professional	52	$14.70	$18.95	$29.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $26.97 / $47.57	Professional	TC	$21.03	$26.97	$47.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $55.47 / $86.14	Professional		$29.41	$55.47	$86.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.90 / $12.65 / $20.99	Professional	26	$9.90	$12.65	$20.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $16.60 / $23.72	Professional	TC	$16.60	$16.60	$23.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $31.95 / $48.03	Professional		$10.71	$31.95	$48.03
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $53.05 / $68.25	Professional		$43.92	$53.05	$68.25
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $12.26 / $13.38	Professional	26	$12.26	$12.26	$13.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.58 / $44.61 / $80.59	Professional		$31.58	$44.61	$80.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $15.20 / $27.42	Professional	26	$10.77	$15.20	$27.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $29.60 / $56.88	Professional	TC	$19.91	$29.60	$56.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $70.00 / $80.00	Facility	26	$36.81	$70.00	$80.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $290.45 / $290.45 / $381.90	Professional		$290.45	$290.45	$381.90
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.68 / $82.68 / $106.35	Professional	26	$82.68	$82.68	$106.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.72 / $207.72 / $275.55	Professional	TC	$207.72	$207.72	$275.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $72.58 / $175.96	Professional		$54.99	$72.58	$175.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $20.82 / $50.48	Professional	26	$16.41	$20.82	$50.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.79 / $51.78 / $125.52	Professional	TC	$40.79	$51.78	$125.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.47 / $48.19 / $87.80	Professional		$15.47	$48.19	$87.80
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.09 / $51.30 / $108.00	Professional		$32.09	$51.30	$108.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $14.61 / $27.05	Professional	26	$11.03	$14.61	$27.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.67 / $29.60 / $56.26	Professional	TC	$19.67	$29.60	$56.26
United Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $42.51 / $70.29	Professional		$33.56	$42.51	$70.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $14.01 / $24.62	Professional	26	$11.77	$14.01	$24.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $29.14 / $52.16	Professional	TC	$20.39	$29.14	$52.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $42.02 / $59.68	Professional		$37.54	$42.02	$59.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $12.38 / $17.07	Professional	26	$10.77	$12.38	$17.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $29.65 / $42.59	Professional	TC	$26.78	$29.65	$42.59