Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.59 / $34.10 / $55.26	Facility	26	$26.59	$34.10	$55.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.72 / $140.41 / $238.03	Professional		$108.72	$140.41	$238.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.51 / $34.10 / $97.57	Professional	26	$26.51	$34.10	$97.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.21 / $96.82 / $170.79	Professional	TC	$82.21	$96.82	$170.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.18 / $92.64 / $240.81	Professional		$55.18	$92.64	$240.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $39.47 / $62.07	Professional	26	$19.39	$39.47	$62.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $85.24 / $255.23	Professional		$23.30	$85.24	$255.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $64.67 / $178.48 / $267.72	Professional		$64.67	$178.48	$267.72
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.57 / $39.07 / $40.67	Professional	26	$38.57	$39.07	$40.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $93.89 / $295.61	Professional		$71.23	$93.89	$295.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.34 / $29.25 / $89.28	Professional	26	$20.34	$29.25	$89.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.12 / $70.36 / $222.21	Professional	TC	$49.12	$70.36	$222.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $99.23 / $239.31 / $239.31	Facility	26	$99.23	$239.31	$239.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,140.80 / $1,140.80 / $1,458.60	Professional		$1,140.80	$1,140.80	$1,458.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $326.98 / $330.05 / $330.38	Professional	26	$326.98	$330.05	$330.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $871.18 / $871.18 / $1,128.23	Professional	TC	$871.18	$871.18	$1,128.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $88.81 / $219.51 / $314.06	Professional		$88.81	$219.51	$314.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.14 / $60.17 / $160.44	Professional	26	$50.14	$60.17	$160.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.93 / $193.11 / $514.96	Professional	TC	$160.93	$193.11	$514.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $152.06 / $297.54	Professional		$44.41	$152.06	$297.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $119.73 / $418.56	Professional		$76.73	$119.73	$418.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.34 / $29.25 / $89.86	Professional	26	$20.34	$29.25	$89.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $48.60 / $70.36 / $218.88	Professional	TC	$48.60	$70.36	$218.88
United Facility/Professional Professional Modifier Low / Median / High Price $87.75 / $110.44 / $305.12	Professional		$87.75	$110.44	$305.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $33.88 / $87.08	Professional	26	$27.50	$33.88	$87.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.95 / $82.94 / $201.10	Professional	TC	$59.95	$82.94	$201.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $73.44 / $170.06	Professional		$73.44	$73.44	$170.06
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $22.60 / $40.67	Professional	26	$21.52	$22.60	$40.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $54.86 / $54.86 / $129.38	Professional	TC	$54.86	$54.86	$129.38