Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $33.82 / $59.43	Facility	26	$30.90	$33.82	$59.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $59.50 / $133.55	Professional		$43.68	$59.50	$133.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.33 / $91.25	Professional	26	$30.90	$40.33	$91.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.63 / $17.57 / $31.66	Professional	TC	$12.63	$17.57	$31.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $68.90 / $68.90	Professional		$68.90	$68.90	$68.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $43.88 / $43.88	Professional	26	$43.88	$43.88	$43.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.85 / $64.52 / $94.66	Professional		$40.85	$64.52	$94.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $75.70 / $99.02	Professional		$61.75	$75.70	$99.02
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $43.63 / $45.35 / $46.16	Professional	26	$43.63	$45.35	$46.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $74.09 / $124.45	Professional		$54.55	$74.09	$124.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.99 / $52.82 / $88.45	Professional	26	$38.99	$52.82	$88.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $21.79 / $35.59	Professional	TC	$16.20	$21.79	$35.59
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $107.57 / $231.56 / $231.56	Facility	26	$107.57	$231.56	$231.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $404.61 / $404.61 / $541.88	Professional		$404.61	$404.61	$541.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $402.86 / $402.86 / $402.86	Professional	26	$402.86	$402.86	$402.86
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $402.86 / $402.86 / $402.86	Professional	TC	$402.86	$402.86	$402.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $105.14 / $143.90	Professional		$61.75	$105.14	$143.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.45 / $74.18 / $102.04	Professional	26	$58.45	$74.18	$102.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $30.95 / $41.89	Professional	TC	$24.39	$30.95	$41.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $58.79 / $104.24	Professional		$22.45	$58.79	$104.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.20 / $74.56 / $128.80	Professional		$53.20	$74.56	$128.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $52.82 / $88.85	Professional	26	$39.22	$52.82	$88.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $21.51 / $35.78	Professional	TC	$16.20	$21.51	$35.78
United Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $76.73 / $111.55	Professional		$53.49	$76.73	$111.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $52.29 / $78.01	Professional	26	$40.00	$52.29	$78.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.75 / $23.83 / $31.68	Professional	TC	$15.75	$23.83	$31.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $61.75 / $86.49	Professional		$54.38	$61.75	$86.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.36 / $44.02 / $61.05	Professional	26	$38.36	$44.02	$61.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.01 / $17.73 / $25.45	Professional	TC	$16.01	$17.73	$25.45