Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $12.09 / $18.05	Facility	26	$9.34	$12.09	$18.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $49.53 / $96.43	Professional		$34.58	$49.53	$96.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $13.50 / $21.87	Professional	26	$9.94	$13.50	$21.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.53 / $35.36 / $60.05	Professional	TC	$24.53	$35.36	$60.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $41.86 / $71.63	Professional		$40.03	$41.86	$71.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.36 / $11.36 / $21.80	Professional	26	$11.36	$11.36	$21.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.03 / $35.72 / $56.73	Professional		$12.03	$35.72	$56.73
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $50.04 / $52.68 / $80.06	Professional		$50.04	$52.68	$80.06
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $13.23 / $14.74	Professional	26	$13.23	$13.23	$14.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $58.98 / $105.06	Professional		$41.16	$58.98	$105.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $16.48 / $29.59	Professional	26	$11.43	$16.48	$29.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.72 / $43.98 / $77.27	Professional	TC	$29.72	$43.98	$77.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $325.58 / $325.58 / $454.50	Professional		$325.58	$325.58	$454.50
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.83 / $91.83 / $112.65	Professional	26	$91.83	$91.83	$112.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $233.75 / $233.75 / $341.85	Professional	TC	$233.75	$233.75	$341.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $86.46 / $209.60	Professional		$65.50	$86.46	$209.60
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.67 / $22.42 / $54.36	Professional	26	$17.67	$22.42	$54.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.47 / $64.05 / $153.32	Professional	TC	$50.47	$64.05	$153.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $47.03 / $94.92	Professional		$15.50	$47.03	$94.92
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $64.56 / $135.43	Professional		$42.65	$64.56	$135.43
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $15.87 / $28.47	Professional	26	$11.78	$15.87	$28.47
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $42.15 / $73.59	Professional	TC	$30.95	$42.15	$73.59
United Facility/Professional Professional Modifier Low / Median / High Price $43.30 / $54.13 / $92.62	Professional		$43.30	$54.13	$92.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $15.16 / $26.03	Professional	26	$11.90	$15.16	$26.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.31 / $39.14 / $66.91	Professional	TC	$31.31	$39.14	$66.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.72 / $50.04 / $71.12	Professional		$44.72	$50.04	$71.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $13.37 / $18.47	Professional	26	$11.60	$13.37	$18.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.13 / $36.67 / $52.65	Professional	TC	$33.13	$36.67	$52.65