Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.03 / $16.27 / $30.78	Facility	26	$16.03	$16.27	$30.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.12 / $37.65 / $133.19	Professional		$26.12	$37.65	$133.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $23.38 / $50.60	Professional	26	$16.14	$23.38	$50.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.86 / $14.08 / $77.37	Professional	TC	$9.86	$14.08	$77.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.87 / $38.39 / $53.75	Professional		$26.87	$38.39	$53.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $30.10 / $46.74	Professional	26	$18.23	$30.10	$46.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $38.63 / $53.74	Professional		$21.55	$38.63	$53.74
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $47.07 / $60.00	Professional		$39.79	$47.07	$60.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $23.92 / $23.92	Professional	26	$22.60	$23.92	$23.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.32 / $64.92 / $142.96	Professional		$35.32	$64.92	$142.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.98 / $29.48 / $49.89	Professional	26	$20.98	$29.48	$49.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.34 / $31.17 / $83.80	Professional	TC	$14.34	$31.17	$83.80
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $55.73 / $120.92 / $120.92	Facility	26	$55.73	$120.92	$120.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $441.00 / $447.52 / $447.52	Professional		$441.00	$447.52	$447.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $338.48 / $338.48 / $338.48	Professional	26	$338.48	$338.48	$338.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.48 / $338.48 / $338.48	Professional	TC	$338.48	$338.48	$338.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.39 / $65.65 / $98.80	Professional		$38.39	$65.65	$98.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.28 / $38.43 / $53.31	Professional	26	$30.28	$38.43	$53.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $27.23 / $47.52	Professional	TC	$21.45	$27.23	$47.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.38 / $33.75 / $65.70	Professional		$19.38	$33.75	$65.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $67.90 / $143.27	Professional		$36.72	$67.90	$143.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $29.65 / $50.37	Professional	26	$21.03	$29.65	$50.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $14.61 / $33.22 / $86.65	Professional	TC	$14.61	$33.22	$86.65
United Facility/Professional Professional Modifier Low / Median / High Price $44.49 / $77.27 / $106.72	Professional		$44.49	$77.27	$106.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.09 / $32.22 / $42.96	Professional	26	$22.09	$32.22	$42.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.15 / $45.00 / $69.66	Professional	TC	$22.15	$45.00	$69.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.96 / $38.39 / $54.00	Professional		$33.96	$38.39	$54.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $22.80 / $31.63	Professional	26	$19.88	$22.80	$31.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $15.59 / $22.37	Professional	TC	$14.08	$15.59	$22.37