Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $7.59 / $13.49	Facility	26	$6.03	$7.59	$13.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $213.80	Professional		$28.84	$46.77	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $35.48	Professional	26	$7.08	$10.00	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $100.00	Professional	TC	$19.95	$32.36	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $50.12	Professional		$25.70	$33.88	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $16.98	Professional	26	$7.08	$9.33	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $43.65	Professional	TC	$21.88	$30.90	$43.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $30.90 / $39.81	Professional		$7.59	$30.90	$39.81
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $72.44	Professional		$34.67	$48.98	$72.44
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $35.48 / $35.48	Professional	26	$8.91	$35.48	$35.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.29 / $10.72 / $15.14	Facility	26	$2.29	$10.72	$15.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $57.54 / $162.18	Professional		$32.36	$57.54	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $20.89	Professional	26	$7.94	$11.48	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $45.71 / $125.89	Professional	TC	$24.55	$45.71	$125.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $524.81 / $549.54	Professional		$47.86	$524.81	$549.54
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	26	$97.72	$97.72	$97.72
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $478.63 / $501.19	Professional	TC	$478.63	$478.63	$501.19
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $7.76 / $12.59	Facility	26	$6.03	$7.76	$12.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.12 / $158.49	Professional		$28.84	$50.12	$158.49
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $30.20	Professional	26	$7.08	$11.22	$30.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $97.72	Professional	TC	$20.89	$36.31	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $32.36 / $33.11	Professional		$7.94	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $40.74 / $112.20	Professional		$9.77	$40.74	$112.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.29 / $10.72 / $15.14	Facility	26	$2.29	$10.72	$15.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $158.49	Professional		$32.36	$58.88	$158.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $19.05	Professional	26	$7.94	$10.47	$19.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $125.89	Professional	TC	$23.99	$42.66	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $97.72	Professional		$33.88	$47.86	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.00 / $17.38	Professional	26	$7.41	$10.00	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $77.62	Professional	TC	$25.70	$37.15	$77.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $39.81 / $46.77	Professional		$38.02	$39.81	$46.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.55 / $11.48	Professional	26	$9.12	$9.55	$11.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $30.20 / $35.48	Professional	TC	$28.18	$30.20	$35.48