Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $52.05 / $123.34	Professional		$42.65	$52.05	$123.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $20.03 / $62.84	Professional	26	$15.31	$20.03	$62.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $31.02 / $88.26	Professional	TC	$27.79	$31.02	$88.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.90 / $36.90 / $36.90	Professional		$36.90	$36.90	$36.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $40.22 / $106.27	Professional		$31.26	$40.22	$106.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $73.36 / $110.66	Professional		$54.11	$73.36	$110.66
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $23.59 / $24.37	Professional	26	$23.25	$23.59	$24.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $40.84 / $132.69	Professional		$27.18	$40.84	$132.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $15.39 / $46.82	Professional	26	$11.79	$15.39	$46.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.96 / $27.85 / $88.69	Professional	TC	$14.96	$27.85	$88.69
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $125.12 / $125.12	Facility	26	$100.00	$125.12	$125.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $453.03 / $453.03 / $698.48	Professional		$453.03	$453.03	$698.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $201.08	Professional	26	$158.49	$158.49	$201.08
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $300.38 / $300.38 / $497.40	Professional	TC	$300.38	$300.38	$497.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $94.86 / $121.31 / $159.90	Professional		$94.86	$121.31	$159.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.33 / $38.82 / $73.59	Professional	26	$30.33	$38.82	$73.59
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.76 / $90.58 / $113.22	Professional	TC	$70.76	$90.58	$113.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.53 / $71.30 / $153.43	Professional		$26.53	$71.30	$153.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $56.32 / $176.85	Professional		$28.00	$56.32	$176.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $15.39 / $46.82	Professional	26	$11.74	$15.39	$46.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $14.85 / $28.52 / $85.27	Professional	TC	$14.85	$28.52	$85.27
United Facility/Professional Professional Modifier Low / Median / High Price $33.49 / $44.50 / $145.08	Professional		$33.49	$44.50	$145.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $16.42 / $54.14	Professional	26	$14.82	$16.42	$54.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $28.29 / $90.94	Professional	TC	$18.98	$28.29	$90.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $41.19 / $80.81	Professional		$28.29	$41.19	$80.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.56 / $12.83 / $24.39	Professional	26	$10.56	$12.83	$24.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $28.36 / $56.43	Professional	TC	$17.73	$28.36	$56.43