Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $97.72	Facility		$51.29	$51.29	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.20 / $75.86	Professional		$19.05	$30.20	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $13.18 / $45.71	Professional	26	$3.98	$13.18	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $22.91 / $69.18	Professional	TC	$14.13	$22.91	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $18.62 / $41.69	Professional		$15.49	$18.62	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $4.27 / $7.76	Professional	26	$3.24	$4.27	$7.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $15.14 / $22.91	Professional	TC	$12.30	$15.14	$22.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $18.20 / $45.71	Professional		$3.63	$18.20	$45.71
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $38.90 / $52.48	Professional		$10.72	$38.90	$52.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $30.90 / $31.62	Facility		$28.84	$30.90	$31.62
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $6.61 / $6.61	Professional	26	$6.31	$6.61	$6.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $23.99 / $69.18	Professional		$15.14	$23.99	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $4.68 / $18.20	Professional	26	$3.16	$4.68	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $19.95 / $58.88	Professional	TC	$11.75	$19.95	$58.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
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 $269.15 / $281.84 / $281.84	Professional		$269.15	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	26	$144.54	$144.54	$144.54
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $234.42	Professional	TC	$229.09	$229.09	$234.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $46.77 / $89.13	Facility		$25.70	$46.77	$89.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $38.90 / $81.28	Professional		$19.05	$38.90	$81.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $8.71 / $38.90	Professional	26	$3.98	$8.71	$38.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $28.18 / $51.29	Professional	TC	$14.13	$28.18	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $32.36 / $33.11	Professional		$5.62	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $30.20 / $66.07	Professional		$7.24	$30.20	$66.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $45.71 / $87.10	Facility		$23.99	$45.71	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $23.99 / $74.13	Professional		$14.79	$23.99	$74.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $3.98 / $15.14	Professional	26	$3.16	$3.98	$15.14
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $18.62 / $58.88	Professional	TC	$11.48	$18.62	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $15.14 / $25.12	Facility		$10.00	$15.14	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.51 / $69.18	Professional		$19.05	$29.51	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $4.57 / $14.45	Professional	26	$3.89	$4.57	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $23.99 / $54.95	Professional	TC	$14.45	$23.99	$54.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $32.36	Professional		$12.30	$12.30	$32.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $2.82 / $6.76	Professional	26	$2.82	$2.82	$6.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $9.33 / $25.70	Professional	TC	$9.33	$9.33	$25.70