Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.53 / $98.53 / $98.53	Facility		$98.53	$98.53	$98.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $26.21 / $65.01	Professional		$19.02	$26.21	$65.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.15 / $6.81 / $20.98	Professional	26	$4.15	$6.81	$20.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.88 / $19.30 / $53.33	Professional	TC	$14.88	$19.30	$53.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.60 / $16.38 / $30.79	Professional		$14.60	$16.38	$30.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.08 / $6.34 / $8.68	Professional	26	$3.08	$6.34	$8.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.25 / $15.14 / $24.45	Professional	TC	$12.25	$15.14	$24.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.80 / $18.27 / $46.49	Professional		$6.80	$18.27	$46.49
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $10.11 / $40.27 / $52.02	Professional		$10.11	$40.27	$52.02
Christus Facility/Professional Facility Modifier Low / Median / High Price $27.57 / $30.73 / $32.75	Facility		$27.57	$30.73	$32.75
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $6.28 / $6.67	Professional	26	$6.20	$6.28	$6.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.96 / $24.27 / $66.09	Professional		$14.96	$24.27	$66.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.17 / $4.37 / $15.70	Professional	26	$3.17	$4.37	$15.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.81 / $20.96 / $55.27	Professional	TC	$11.81	$20.96	$55.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $97.31 / $178.89 / $178.89	Facility		$97.31	$178.89	$178.89
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 $263.07 / $270.27 / $282.08	Professional		$263.07	$270.27	$282.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.30 / $145.30 / $145.30	Professional	26	$145.30	$145.30	$145.30
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.21 / $227.48 / $232.41	Professional	TC	$226.21	$227.48	$232.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $27.84 / $49.26 / $76.00	Facility		$27.84	$49.26	$76.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $9.35 / $42.06 / $86.00	Professional		$9.35	$42.06	$86.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $10.35 / $48.53	Professional	26	$8.09	$10.35	$48.53
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.35 / $41.41 / $51.76	Professional	TC	$32.35	$41.41	$51.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.02 / $28.37 / $58.19	Professional		$7.02	$28.37	$58.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $27.73 / $50.55 / $83.20	Facility		$27.73	$50.55	$83.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.40 / $32.56 / $83.87	Professional		$15.40	$32.56	$83.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.17 / $4.13 / $15.70	Professional	26	$3.17	$4.13	$15.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.52 / $18.42 / $58.95	Professional	TC	$11.52	$18.42	$58.95
United Facility/Professional Professional Modifier Low / Median / High Price $18.84 / $29.42 / $69.08	Professional		$18.84	$29.42	$69.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.88 / $4.51 / $14.44	Professional	26	$3.88	$4.51	$14.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $24.18 / $53.20	Professional	TC	$14.51	$24.18	$53.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.25 / $22.33 / $32.27	Professional		$12.25	$22.33	$32.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $3.46 / $6.48	Professional	26	$2.82	$3.46	$6.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $9.43 / $19.73 / $25.79	Professional	TC	$9.43	$19.73	$25.79