Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $49.29 / $99.63	Professional		$39.59	$49.29	$99.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $20.14 / $42.49	Professional	26	$15.47	$20.14	$42.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.10 / $29.75 / $64.12	Professional	TC	$24.10	$29.75	$64.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $37.17 / $74.34	Professional		$35.54	$37.17	$74.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $25.75 / $42.49	Professional	26	$12.88	$25.75	$42.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.93 / $54.05 / $97.73	Professional		$32.93	$54.05	$97.73
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $105.46 / $175.77	Professional		$74.34	$105.46	$175.77
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.16 / $26.41 / $66.84	Professional	26	$25.16	$26.41	$66.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $42.42 / $127.46	Professional		$30.49	$42.42	$127.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.30 / $16.64 / $50.56	Professional	26	$13.30	$16.64	$50.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.92 / $82.20	Professional	TC	$17.78	$25.92	$82.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $134.76 / $134.76	Facility	26	$100.00	$134.76	$134.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $424.65 / $424.65 / $668.70	Professional		$424.65	$424.65	$668.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $214.00 / $214.00 / $216.60	Professional	26	$214.00	$214.00	$216.60
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.93 / $272.93 / $452.18	Professional	TC	$272.93	$272.93	$452.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.29 / $104.80 / $150.00	Professional		$64.29	$104.80	$150.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.75 / $39.29 / $60.15	Professional	26	$32.75	$39.29	$60.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.29 / $77.15 / $144.38	Professional	TC	$64.29	$77.15	$144.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $69.97 / $154.97	Professional		$28.98	$69.97	$154.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.38 / $60.05 / $167.80	Professional		$31.38	$60.05	$167.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $16.64 / $50.56	Professional	26	$13.26	$16.64	$50.56
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.45 / $25.92 / $78.70	Professional	TC	$18.45	$25.92	$78.70
United Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $45.97 / $139.30	Professional		$39.14	$45.97	$139.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $19.00 / $58.46	Professional	26	$16.82	$19.00	$58.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $27.92 / $80.84	Professional	TC	$24.25	$27.92	$80.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $39.14 / $77.62	Professional		$27.16	$39.14	$77.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $13.88 / $26.35	Professional	26	$11.40	$13.88	$26.35
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.76 / $25.26 / $51.27	Professional	TC	$15.76	$25.26	$51.27