Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.94 / $22.13 / $36.63	Facility	26	$16.94	$22.13	$36.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.69 / $92.43 / $149.54	Professional		$67.69	$92.43	$149.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $24.52 / $44.75	Professional	26	$18.70	$24.52	$44.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.11 / $67.09 / $113.68	Professional	TC	$48.11	$67.09	$113.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $127.62 / $188.09	Professional		$64.23	$127.62	$188.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $34.97 / $48.38	Professional	26	$19.85	$34.97	$48.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $70.02 / $103.87	Professional		$21.69	$70.02	$103.87
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $91.75 / $105.51 / $119.00	Professional		$91.75	$105.51	$119.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.56 / $24.56 / $26.67	Professional	26	$24.56	$24.56	$26.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $103.60 / $186.71	Professional		$74.23	$103.60	$186.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.09 / $29.08 / $52.68	Professional	26	$21.09	$29.08	$52.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.76 / $75.98 / $139.69	Professional	TC	$52.76	$75.98	$139.69
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $127.92 / $127.92	Facility	26	$80.00	$127.92	$127.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $642.13 / $642.13 / $832.58	Professional		$642.13	$642.13	$832.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $167.46 / $167.46 / $210.75	Professional	26	$167.46	$167.46	$210.75
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $474.67 / $474.67 / $621.90	Professional	TC	$474.67	$474.67	$621.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.75 / $158.52 / $237.25	Professional		$91.75	$158.52	$237.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $41.63 / $100.92	Professional	26	$32.79	$41.63	$100.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $92.09 / $116.89 / $283.36	Professional	TC	$92.09	$116.89	$283.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.98 / $137.80 / $270.89	Professional		$27.98	$137.80	$270.89
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.22 / $117.38 / $251.40	Professional		$78.22	$117.38	$251.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.59 / $28.49 / $52.11	Professional	26	$21.59	$28.49	$52.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $52.76 / $75.36 / $137.49	Professional	TC	$52.76	$75.36	$137.49
United Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $96.72 / $156.86	Professional		$79.27	$96.72	$156.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $27.08 / $45.54	Professional	26	$22.67	$27.08	$45.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.57 / $70.11 / $114.81	Professional	TC	$54.57	$70.11	$114.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.99 / $91.75 / $130.41	Professional		$81.99	$91.75	$130.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.53 / $24.81 / $34.22	Professional	26	$21.53	$24.81	$34.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $60.46 / $66.94 / $96.19	Professional	TC	$60.46	$66.94	$96.19