Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.99 / $51.12 / $117.93	Professional		$38.99	$51.12	$117.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.66 / $23.19 / $84.15	Professional	26	$13.66	$23.19	$84.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $33.52 / $67.04	Professional	TC	$25.35	$33.52	$67.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $64.97 / $130.29	Professional		$32.52	$64.97	$130.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $20.65 / $28.86	Professional	26	$10.32	$20.65	$28.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.59 / $23.59 / $23.59	Professional	TC	$23.59	$23.59	$23.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.15 / $32.15 / $32.15	Facility		$32.15	$32.15	$32.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.09 / $54.05 / $93.46	Professional		$27.09	$54.05	$93.46
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $61.41 / $85.97 / $115.00	Professional		$61.41	$85.97	$115.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $22.04 / $64.77 / $68.55	Facility		$22.04	$64.77	$68.55
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $20.45 / $21.34	Professional	26	$20.17	$20.45	$21.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $42.80 / $125.96	Professional		$30.23	$42.80	$125.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $16.27 / $45.64	Professional	26	$10.69	$16.27	$45.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $28.86 / $80.72	Professional	TC	$18.87	$28.86	$80.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $171.77 / $373.45 / $373.45	Facility		$171.77	$373.45	$373.45
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $113.52 / $113.52	Facility	26	$100.00	$113.52	$113.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $407.64 / $407.64 / $585.60	Professional		$407.64	$407.64	$585.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $244.00 / $244.00 / $244.00	Professional	26	$244.00	$244.00	$244.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $268.50 / $268.50 / $411.38	Professional	TC	$268.50	$268.50	$411.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.37 / $78.55 / $113.70	Facility		$48.37	$78.55	$113.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $84.91 / $126.35	Professional		$30.86	$84.91	$126.35
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.29 / $31.55 / $49.50	Professional	26	$26.29	$31.55	$49.50
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.01 / $70.34 / $126.35	Professional	TC	$55.01	$70.34	$126.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $61.27 / $128.56	Professional		$23.30	$61.27	$128.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.37 / $78.55 / $122.85	Facility		$48.37	$78.55	$122.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $61.41 / $160.99	Professional		$31.36	$61.41	$160.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $14.39 / $45.64	Professional	26	$10.69	$14.39	$45.64
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $29.28 / $80.72	Professional	TC	$18.87	$29.28	$80.72
United Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $43.82 / $126.32	Professional		$37.90	$43.82	$126.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $16.14 / $50.20	Professional	26	$14.08	$16.14	$50.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $29.64 / $79.40	Professional	TC	$23.82	$29.64	$79.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.63 / $35.51 / $67.91	Professional		$24.63	$35.51	$67.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $11.27 / $21.14	Professional	26	$9.15	$11.27	$21.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.48 / $24.25 / $46.78	Professional	TC	$15.48	$24.25	$46.78