Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.47 / $150.10 / $192.18	Facility		$15.47	$150.10	$192.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.97 / $2.41 / $2.77	Facility	26	$1.97	$2.41	$2.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.05 / $25.84 / $41.91	Professional		$16.05	$25.84	$41.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.19 / $2.98 / $5.51	Professional	26	$2.19	$2.98	$5.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $7.84 / $10.70 / $16.41	Professional	52	$7.84	$10.70	$16.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.51 / $19.35 / $34.51	Professional	TC	$13.51	$19.35	$34.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.69 / $19.69 / $21.17	Professional		$19.69	$19.69	$21.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.86 / $150.18 / $290.99	Facility		$58.86	$150.18	$290.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.41 / $16.37 / $31.37	Professional		$2.41	$16.37	$31.37
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $22.15 / $66.33 / $136.27	Facility		$22.15	$66.33	$136.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $23.29 / $23.29 / $23.29	Professional		$23.29	$23.29	$23.29
Christus Facility/Professional Facility Modifier Low / Median / High Price $22.07 / $22.07 / $22.67	Facility		$22.07	$22.07	$22.67
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $2.94 / $20.67 / $20.67	Professional	26	$2.94	$20.67	$20.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $30.94	Facility		$26.10	$26.10	$30.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.85 / $30.67 / $63.82	Professional		$20.85	$30.67	$63.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.85 / $4.40 / $13.88	Professional	26	$2.85	$4.40	$13.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $25.99 / $46.91	Professional	TC	$18.03	$25.99	$46.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $68.06 / $132.93 / $132.93	Facility		$68.06	$132.93	$132.93
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.48 / $100.00 / $100.00	Facility	26	$13.48	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $311.26 / $311.26 / $311.26	Professional		$311.26	$311.26	$311.26
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.00 / $129.00 / $129.00	Professional	26	$129.00	$129.00	$129.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $252.63 / $252.63 / $252.63	Professional	TC	$252.63	$252.63	$252.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $18.50 / $30.15 / $61.07	Facility		$18.50	$30.15	$61.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $36.83 / $51.77	Professional		$28.46	$36.83	$51.77
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.78 / $4.80 / $6.84	Professional	26	$3.78	$4.80	$6.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.23 / $32.03 / $41.81	Professional	TC	$25.23	$32.03	$41.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.64 / $26.09 / $42.34	Professional		$3.64	$26.09	$42.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $18.78 / $30.32 / $61.34	Facility		$18.78	$30.32	$61.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.36 / $33.46 / $62.55	Professional		$21.36	$33.46	$62.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $2.86 / $4.30 / $14.25	Professional	26	$2.86	$4.30	$14.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.34 / $25.99 / $45.20	Professional	TC	$18.34	$25.99	$45.20
United Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $24.51 / $57.04	Professional		$17.89	$24.51	$57.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.74 / $3.58 / $13.50	Professional	26	$2.74	$3.58	$13.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.63 / $20.61 / $40.99	Professional	TC	$15.63	$20.61	$40.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $21.17 / $30.24	Professional		$19.05	$21.17	$30.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.48 / $2.84 / $3.92	Professional	26	$2.48	$2.84	$3.92
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $18.34 / $26.33	Professional	TC	$16.57	$18.34	$26.33