Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Facility		$25.70	$25.70	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $14.13 / $37.15	Professional		$8.91	$14.13	$37.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $5.01 / $20.42	Professional	26	$2.00	$5.01	$20.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $10.00 / $22.91	Professional	TC	$6.03	$10.00	$22.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $9.77 / $20.89	Professional		$7.59	$9.77	$20.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.04 / $4.07 / $5.75	Professional	26	$2.04	$4.07	$5.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $7.24 / $9.77	Professional	TC	$6.03	$7.24	$9.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.82 / $9.12 / $22.91	Professional		$2.82	$9.12	$22.91
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $20.89 / $36.31	Professional		$14.79	$20.89	$36.31
Christus Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $15.49 / $15.85	Facility		$14.13	$15.49	$15.85
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $4.27 / $4.37	Professional	26	$4.07	$4.27	$4.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $11.75 / $33.88	Professional		$7.41	$11.75	$33.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.09 / $3.09 / $11.22	Professional	26	$2.09	$3.09	$11.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.25 / $8.71 / $25.70	Professional	TC	$5.25	$8.71	$25.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $100.00	Facility		$95.50	$95.50	$100.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $141.25	Professional		$125.89	$141.25	$141.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	26	$87.10	$87.10	$87.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $104.71 / $104.71	Professional	TC	$100.00	$104.71	$104.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $23.44 / $45.71	Facility		$12.88	$23.44	$45.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $19.50 / $38.02	Professional		$8.91	$19.50	$38.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.24 / $5.62 / $16.98	Professional	26	$2.24	$5.62	$16.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $14.45 / $23.99	Professional	TC	$6.03	$14.45	$23.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $32.36 / $33.11	Professional		$3.63	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.79 / $15.85 / $33.88	Professional		$4.79	$15.85	$33.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $23.44 / $46.77	Facility		$12.02	$23.44	$46.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $11.48 / $39.81	Professional		$7.41	$11.48	$39.81
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $2.09 / $2.57 / $10.00	Professional	26	$2.09	$2.57	$10.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $5.25 / $8.51 / $25.70	Professional	TC	$5.25	$8.51	$25.70
United Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $7.94 / $13.18	Facility		$5.25	$7.94	$13.18
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $13.49 / $34.67	Professional		$9.55	$13.49	$34.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.63 / $3.02 / $9.33	Professional	26	$2.63	$3.02	$9.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $11.22 / $25.12	Professional	TC	$6.76	$11.22	$25.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $6.17 / $16.60	Professional		$6.17	$6.17	$16.60
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $1.82 / $1.82 / $4.47	Professional	26	$1.82	$1.82	$4.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $4.37 / $4.37 / $12.02	Professional	TC	$4.37	$4.37	$12.02