Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $12.59 / $12.59 / $12.59	Facility	TC	$12.59	$12.59	$12.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $16.98 / $38.90	Professional		$12.02	$16.98	$38.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $20.42 / $77.62	Professional	26	$7.59	$20.42	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $6.76 / $19.95	Professional	TC	$5.01	$6.76	$19.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.23 / $19.95	Professional		$10.00	$10.23	$19.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $11.22 / $15.49	Professional	26	$5.62	$11.22	$15.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $3.98 / $4.07 / $7.59	Professional	TC	$3.98	$4.07	$7.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6.46 / $6.46 / $6.46	Facility		$6.46	$6.46	$6.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $16.22 / $27.54	Professional		$6.46	$16.22	$27.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $25.12 / $32.36	Professional		$17.78	$25.12	$32.36
Christus Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $19.05 / $19.05	Facility		$12.02	$19.05	$19.05
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $7.59 / $7.94 / $7.94	Facility	TC	$7.59	$7.94	$7.94
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $11.22	Professional	26	$10.96	$11.22	$11.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $12.59 / $44.67	Professional		$9.12	$12.59	$44.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.51 / $26.30	Professional	26	$5.75	$8.51	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $4.68 / $14.79	Professional	TC	$3.09	$4.68	$14.79
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $169.82	Professional		$131.83	$169.82	$169.82
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $97.72 / $97.72	Professional	26	$95.50	$97.72	$97.72
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	TC	$95.50	$95.50	$95.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $23.99 / $40.74	Facility		$16.22	$23.99	$40.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $22.91 / $44.67	Professional		$12.02	$22.91	$44.67
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.14 / $50.12	Professional	26	$7.08	$15.14	$50.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $9.33 / $16.60	Professional	TC	$5.01	$9.33	$16.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $32.36 / $33.11	Professional		$9.55	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $19.95 / $41.69	Professional		$8.91	$19.95	$41.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $23.99 / $40.74	Facility		$15.49	$23.99	$40.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $12.59 / $48.98	Professional		$9.12	$12.59	$48.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $6.92 / $25.70	Professional	26	$5.75	$6.92	$25.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $4.57 / $14.79	Professional	TC	$3.09	$4.57	$14.79
United Facility/Professional Facility Modifier Low / Median / High Price $7.24 / $10.96 / $18.20	Facility		$7.24	$10.96	$18.20
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $13.49 / $43.65	Professional		$10.96	$13.49	$43.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.94 / $25.70	Professional	26	$7.08	$7.94	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $5.62 / $18.20	Professional	TC	$3.80	$5.62	$18.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $8.51 / $19.95	Professional		$8.51	$8.51	$19.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $5.13 / $11.48	Professional	26	$5.13	$5.13	$11.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $3.55 / $3.55 / $8.51	Professional	TC	$3.55	$3.55	$8.51