Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.41 / $17.41 / $27.62	Facility	26	$13.41	$17.41	$27.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.64 / $97.46	Professional		$44.67	$58.64	$97.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.46 / $18.80 / $31.42	Professional	26	$14.46	$18.80	$31.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.24 / $39.01 / $66.03	Professional	TC	$30.24	$39.01	$66.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $19.73 / $33.86	Professional	26	$15.78	$19.73	$33.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.41 / $46.71 / $78.12	Professional		$20.41	$46.71	$78.12
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $82.90 / $98.30	Professional		$60.68	$82.90	$98.30
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $19.53 / $21.27	Professional	26	$19.53	$19.53	$21.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $70.55 / $125.48	Professional		$50.95	$70.55	$125.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $23.78 / $43.04	Professional	26	$16.80	$23.78	$43.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.33 / $47.97 / $86.91	Professional	TC	$33.33	$47.97	$86.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $68.72 / $101.94 / $101.94	Facility	26	$68.72	$101.94	$101.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $420.07 / $420.07 / $547.20	Professional		$420.07	$420.07	$547.20
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $132.09 / $166.95	Professional	26	$132.09	$132.09	$166.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.04 / $288.04 / $380.25	Professional	TC	$288.04	$288.04	$380.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.25 / $104.61 / $253.60	Professional		$79.25	$104.61	$253.60
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $33.08 / $80.20	Professional	26	$26.07	$33.08	$80.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.34 / $71.51 / $173.36	Professional	TC	$56.34	$71.51	$173.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.26 / $132.60 / $202.50	Professional		$22.26	$132.60	$202.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.19 / $79.16 / $167.32	Professional		$52.19	$79.16	$167.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.45 / $23.08 / $42.59	Professional	26	$17.45	$23.08	$42.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.33 / $46.60 / $85.08	Professional	TC	$33.33	$46.60	$85.08
United Facility/Professional Professional Modifier Low / Median / High Price $51.62 / $65.86 / $103.25	Professional		$51.62	$65.86	$103.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.19 / $22.11 / $36.54	Professional	26	$18.19	$22.11	$36.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.31 / $44.25 / $70.55	Professional	TC	$35.31	$44.25	$70.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $60.68 / $86.09	Professional		$54.11	$60.68	$86.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $19.73 / $27.23	Professional	26	$17.11	$19.73	$27.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.99 / $40.96 / $58.87	Professional	TC	$36.99	$40.96	$58.87