Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $75.62 / $172.25	Professional		$43.68	$75.62	$172.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $18.26 / $67.40	Professional	26	$7.34	$18.26	$67.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.52 / $54.90 / $122.00	Professional	TC	$41.52	$54.90	$122.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $40.04 / $75.62	Professional		$25.25	$40.04	$75.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.87 / $5.79 / $15.62	Professional	26	$3.87	$5.79	$15.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $34.29 / $51.21	Professional	TC	$21.49	$34.29	$51.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.75 / $115.75 / $115.75	Facility		$115.75	$115.75	$115.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.59 / $41.47 / $115.75	Professional		$14.59	$41.47	$115.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $99.27 / $120.85	Professional		$29.00	$99.27	$120.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $36.42 / $75.51 / $80.00	Facility		$36.42	$75.51	$80.00
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $61.64 / $64.48 / $68.59	Facility	TC	$61.64	$64.48	$68.59
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $11.01 / $11.57	Professional	26	$10.87	$11.01	$11.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.13 / $45.88 / $132.50	Professional		$32.13	$45.88	$132.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $7.27 / $27.48	Professional	26	$5.63	$7.27	$27.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $36.11 / $119.00	Professional	TC	$27.01	$36.11	$119.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $201.28 / $444.13 / $444.13	Facility		$201.28	$444.13	$444.13
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 $172.33 / $386.32 / $386.32	Facility	TC	$172.33	$386.32	$386.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $514.55 / $514.55 / $692.33	Professional		$514.55	$514.55	$692.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $87.52 / $94.35	Professional	26	$87.52	$87.52	$94.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $439.92 / $439.92 / $598.04	Professional	TC	$439.92	$439.92	$598.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.36 / $78.73 / $126.58	Facility		$38.36	$78.73	$126.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $81.63 / $148.00	Professional		$13.46	$81.63	$148.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $16.98 / $26.64	Professional	26	$14.15	$16.98	$26.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.31 / $102.38 / $154.57	Professional	TC	$85.31	$102.38	$154.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.86 / $73.45 / $144.76	Professional		$11.86	$73.45	$144.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.36 / $78.51 / $132.34	Facility		$38.36	$78.51	$132.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $64.88 / $195.11	Professional		$32.90	$64.88	$195.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $7.27 / $30.00	Professional	26	$5.63	$7.27	$30.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $37.02 / $110.53	Professional	TC	$27.01	$37.02	$110.53
United Facility/Professional Professional Modifier Low / Median / High Price $41.46 / $46.34 / $154.46	Professional		$41.46	$46.34	$154.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $7.58 / $25.26	Professional	26	$6.94	$7.58	$25.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.94 / $39.51 / $129.19	Professional	TC	$33.94	$39.51	$129.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $42.87 / $79.45	Professional		$28.80	$42.87	$79.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.93 / $6.06 / $11.37	Professional	26	$4.93	$6.06	$11.37
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $36.81 / $68.08	Professional	TC	$23.76	$36.81	$68.08