Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.21 / $28.90 / $45.91	Facility	26	$22.21	$28.90	$45.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.77 / $268.43 / $496.60	Professional		$201.77	$268.43	$496.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.21 / $33.35 / $101.76	Professional	26	$22.21	$33.35	$101.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.56 / $236.49 / $451.51	Professional	TC	$179.56	$236.49	$451.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.87 / $56.45 / $63.93	Professional	26	$27.87	$56.45	$63.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $230.82 / $320.25	Professional		$28.68	$230.82	$320.25
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $167.00 / $427.55 / $509.65	Professional		$167.00	$427.55	$509.65
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $32.45 / $213.68 / $213.68	Professional	26	$32.45	$213.68	$213.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.17 / $365.91 / $671.99	Professional		$232.17	$365.91	$671.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.68 / $42.10 / $68.87	Professional	26	$28.68	$42.10	$68.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.41 / $326.52 / $605.04	Professional	TC	$210.41	$326.52	$605.04
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $81.73 / $168.58 / $168.58	Facility	26	$81.73	$168.58	$168.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,991.14 / $1,991.14 / $2,452.35	Professional		$1,991.14	$1,991.14	$2,452.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $218.97 / $218.97 / $277.95	Professional	26	$218.97	$218.97	$277.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,772.11 / $1,772.11 / $2,174.40	Professional	TC	$1,772.11	$1,772.11	$2,174.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $464.33 / $701.27	Professional		$61.20	$464.33	$701.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.58 / $59.48 / $133.28	Professional	26	$47.58	$59.48	$133.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.29 / $442.86 / $992.40	Professional	TC	$354.29	$442.86	$992.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.39 / $467.63 / $949.50	Professional		$60.39	$467.63	$949.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $243.02 / $368.14 / $679.96	Professional		$243.02	$368.14	$679.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.26 / $43.61 / $68.87	Professional	26	$29.26	$43.61	$68.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $224.05 / $341.90 / $636.20	Professional	TC	$224.05	$341.90	$636.20
United Facility/Professional Professional Modifier Low / Median / High Price $270.82 / $328.46 / $507.78	Professional		$270.82	$328.46	$507.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $35.75 / $55.76	Professional	26	$28.11	$35.75	$55.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.23 / $301.27 / $468.18	Professional	TC	$239.23	$301.27	$468.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $240.17 / $267.22 / $382.24	Professional		$240.17	$267.22	$382.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.44 / $32.79 / $45.20	Professional	26	$28.44	$32.79	$45.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $211.75 / $234.44 / $337.05	Professional	TC	$211.75	$234.44	$337.05