Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.95 / $24.92 / $43.68	Facility	26	$20.95	$24.92	$43.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $96.97 / $182.40	Professional		$83.50	$96.97	$182.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.79 / $24.95 / $51.48	Professional	26	$20.79	$24.95	$51.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.70 / $69.06 / $127.17	Professional	TC	$62.70	$69.06	$127.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $59.68 / $149.54	Professional		$40.93	$59.68	$149.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $26.61 / $43.45	Professional	26	$16.04	$26.61	$43.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $64.48 / $193.08	Professional		$23.82	$64.48	$193.08
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.01 / $125.51 / $170.18	Professional		$48.01	$125.51	$170.18
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $30.88 / $32.14	Professional	26	$30.50	$30.88	$32.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $69.91 / $220.63	Professional		$46.40	$69.91	$220.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $18.10 / $57.74	Professional	26	$13.00	$18.10	$57.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.40 / $52.25 / $163.38	Professional	TC	$33.40	$52.25	$163.38
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $162.63 / $162.63	Facility	26	$85.00	$162.63	$162.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $875.57 / $875.57 / $1,079.93	Professional		$875.57	$875.57	$1,079.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $212.17 / $212.17 / $261.23	Professional	26	$212.17	$212.17	$261.23
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $663.40 / $663.40 / $818.70	Professional	TC	$663.40	$663.40	$818.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $119.53 / $175.25 / $308.37	Professional		$119.53	$175.25	$308.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.63 / $47.55 / $126.80	Professional	26	$39.63	$47.55	$126.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $116.85 / $140.22 / $373.92	Professional	TC	$116.85	$140.22	$373.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.32 / $111.91 / $220.47	Professional		$34.32	$111.91	$220.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $83.13 / $316.64	Professional		$46.40	$83.13	$316.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $18.10 / $57.92	Professional	26	$13.00	$18.10	$57.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.04 / $50.59 / $166.65	Professional	TC	$33.04	$50.59	$166.65
United Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $84.23 / $210.59	Professional		$58.46	$84.23	$210.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $21.65 / $59.13	Professional	26	$16.34	$21.65	$59.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.12 / $62.58 / $156.44	Professional	TC	$42.12	$62.58	$156.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $54.75 / $126.07	Professional		$54.00	$54.75	$126.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $14.69 / $32.18	Professional	26	$14.69	$14.69	$32.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.31 / $40.68 / $93.89	Professional	TC	$39.31	$40.68	$93.89