Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.00 / $24.00 / $43.15	Facility	26	$22.00	$24.00	$43.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $73.45 / $722.00	Professional		$44.39	$73.45	$722.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $38.04 / $386.10	Professional	26	$22.00	$38.04	$386.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.12 / $31.60 / $74.72	Professional	TC	$22.12	$31.60	$74.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.27 / $62.84 / $97.31	Professional		$50.27	$62.84	$97.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $34.49 / $54.25	Professional	26	$30.58	$34.49	$54.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.73 / $53.74 / $87.14	Professional		$26.73	$53.74	$87.14
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $78.55 / $107.58	Professional		$65.34	$78.55	$107.58
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $31.07 / $98.34 / $98.34	Professional	26	$31.07	$98.34	$98.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.47 / $78.73 / $135.49	Professional		$56.47	$78.73	$135.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $37.64 / $63.11	Professional	26	$27.65	$37.64	$63.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.74 / $41.93 / $69.89	Professional	TC	$28.74	$41.93	$69.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $76.59 / $170.00 / $170.00	Facility	26	$76.59	$170.00	$170.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $468.00 / $468.11 / $560.92	Professional		$468.00	$468.11	$560.92
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $378.10 / $378.10 / $378.10	Professional	26	$378.10	$378.10	$378.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $378.10 / $378.10 / $378.10	Professional	TC	$378.10	$378.10	$378.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.69 / $96.17 / $133.28	Professional		$45.69	$96.17	$133.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.63 / $52.83 / $72.34	Professional	26	$41.63	$52.83	$72.34
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.32 / $54.98 / $73.11	Professional	TC	$43.32	$54.98	$73.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.99 / $54.21 / $114.83	Professional		$35.99	$54.21	$114.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $79.65 / $136.57	Professional		$57.06	$79.65	$136.57
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.87 / $37.64 / $65.04	Professional	26	$27.87	$37.64	$65.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.74 / $41.93 / $69.97	Professional	TC	$28.74	$41.93	$69.97
United Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $84.81 / $115.35	Professional		$57.67	$84.81	$115.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $36.95 / $53.00	Professional	26	$27.57	$36.95	$53.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.86 / $44.23 / $60.59	Professional	TC	$30.86	$44.23	$60.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.77 / $62.84 / $88.71	Professional		$55.77	$62.84	$88.71
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.33 / $31.35 / $43.47	Professional	26	$27.33	$31.35	$43.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.44 / $31.48 / $45.24	Professional	TC	$28.44	$31.48	$45.24