Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.09 / $43.02 / $92.32	Professional		$33.09	$43.02	$92.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.49 / $27.73 / $80.26	Professional	26	$21.49	$27.73	$80.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.60 / $15.05 / $33.28	Professional	TC	$11.60	$15.05	$33.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.44 / $52.88 / $55.05	Professional		$26.44	$52.88	$55.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $20.37 / $44.16	Professional	26	$16.35	$20.37	$44.16
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.09 / $10.09 / $18.14	Professional	TC	$10.09	$10.09	$18.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $57.96 / $78.28	Professional		$30.76	$57.96	$78.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.59 / $74.03 / $92.04	Professional		$47.59	$74.03	$92.04
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $31.93 / $32.40 / $33.47	Professional	26	$31.93	$32.40	$33.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $32.11 / $99.42	Professional		$25.38	$32.11	$99.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.06 / $21.23 / $65.44	Professional	26	$15.06	$21.23	$65.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $11.24 / $35.54	Professional	TC	$9.18	$11.24	$35.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $172.05 / $172.05	Facility	26	$100.00	$172.05	$172.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $473.28 / $473.28 / $473.28	Professional		$473.28	$473.28	$473.28
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $346.00 / $346.00 / $346.00	Professional	26	$346.00	$346.00	$346.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $330.22 / $330.22 / $330.22	Professional	TC	$330.22	$330.22	$330.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.58 / $72.13 / $102.00	Professional		$39.58	$72.13	$102.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.65 / $49.98 / $77.66	Professional	26	$41.65	$49.98	$77.66
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.69 / $32.03 / $43.41	Professional	TC	$26.69	$32.03	$43.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $50.46 / $103.37	Professional		$23.12	$50.46	$103.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $53.07 / $135.44	Professional		$25.38	$53.07	$135.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $21.19 / $65.79	Professional	26	$14.93	$21.19	$65.79
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $11.24 / $35.54	Professional	TC	$9.18	$11.24	$35.54
United Facility/Professional Professional Modifier Low / Median / High Price $31.86 / $35.42 / $114.04	Professional		$31.86	$35.42	$114.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.22 / $23.04 / $75.06	Professional	26	$20.22	$23.04	$75.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.69 / $13.03 / $38.97	Professional	TC	$11.69	$13.03	$38.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.24 / $28.86 / $54.78	Professional		$22.24	$28.86	$54.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.64 / $17.69 / $33.51	Professional	26	$14.64	$17.69	$33.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $7.60 / $11.17 / $21.27	Professional	TC	$7.60	$11.17	$21.27