Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.05 / $7.86 / $13.14	Facility	26	$6.05	$7.86	$13.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.49 / $41.69 / $165.07	Professional		$25.49	$41.69	$165.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.40 / $22.98	Professional	26	$6.55	$9.40	$22.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.61 / $28.00 / $96.77	Professional	TC	$18.61	$28.00	$96.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.49 / $32.82 / $57.97	Professional		$25.49	$32.82	$57.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $9.34 / $17.38	Professional	26	$7.09	$9.34	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $22.01 / $23.22	Professional	TC	$22.01	$22.01	$23.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.69 / $28.12 / $39.79	Professional		$7.69	$28.12	$39.79
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $36.46 / $51.40 / $72.84	Professional		$36.46	$51.40	$72.84
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.82 / $9.51 / $35.28	Professional	26	$8.82	$9.51	$35.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.25 / $54.63 / $156.11	Professional		$31.25	$54.63	$156.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.10 / $20.23	Professional	26	$7.59	$11.10	$20.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $43.62 / $126.88	Professional	TC	$23.78	$43.62	$126.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.19 / $70.00 / $80.00	Facility	26	$53.19	$70.00	$80.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $528.05 / $539.95 / $554.75	Professional		$528.05	$539.95	$554.75
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.55 / $97.55 / $97.55	Professional	26	$97.55	$97.55	$97.55
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $477.35 / $492.53 / $506.03	Professional	TC	$477.35	$492.53	$506.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.52 / $57.26 / $238.50	Professional		$16.52	$57.26	$238.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $14.95 / $36.24	Professional	26	$11.78	$14.95	$36.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.84 / $48.03 / $116.44	Professional	TC	$37.84	$48.03	$116.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.27 / $35.52 / $71.22	Professional		$10.27	$35.52	$71.22
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $63.35 / $145.80	Professional		$32.36	$63.35	$145.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $10.68 / $19.78	Professional	26	$7.89	$10.68	$19.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $42.87 / $125.51	Professional	TC	$23.82	$42.87	$125.51
United Facility/Professional Professional Modifier Low / Median / High Price $32.13 / $48.07 / $97.71	Professional		$32.13	$48.07	$97.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $10.11 / $17.19	Professional	26	$7.48	$10.11	$17.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.46 / $36.10 / $82.19	Professional	TC	$25.46	$36.10	$82.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.58 / $36.42 / $51.81	Professional		$32.58	$36.42	$51.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $8.91 / $12.29	Professional	26	$7.73	$8.91	$12.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $27.51 / $39.51	Professional	TC	$24.84	$27.51	$39.51