Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.32 / $27.42 / $44.95	Facility	26	$20.32	$27.42	$44.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $65.53 / $96.32	Professional		$45.50	$65.53	$96.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.88 / $32.56 / $48.01	Professional	26	$24.88	$32.56	$48.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $33.03 / $52.42	Professional	TC	$19.27	$33.03	$52.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.62 / $68.17 / $80.56	Professional		$60.62	$68.17	$80.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.88 / $29.97 / $36.70	Professional	26	$24.88	$29.97	$36.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.70 / $32.70 / $32.70	Professional	TC	$32.70	$32.70	$32.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $52.14 / $92.30	Professional		$26.93	$52.14	$92.30
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $71.27 / $99.15 / $120.38	Professional		$71.27	$99.15	$120.38
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.68 / $28.68 / $30.35	Professional	26	$28.68	$28.68	$30.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $78.56 / $128.91	Professional		$57.01	$78.56	$128.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.91 / $42.50 / $71.50	Professional	26	$30.91	$42.50	$71.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.52 / $34.85 / $59.95	Professional	TC	$20.52	$34.85	$59.95
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $72.78 / $145.80 / $152.05	Facility	26	$72.78	$145.80	$152.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $486.90 / $486.90 / $550.58	Professional		$486.90	$486.90	$550.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $196.52 / $196.52 / $246.68	Professional	26	$196.52	$196.52	$246.68
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.63 / $244.63 / $303.83	Professional	TC	$244.63	$244.63	$303.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.37 / $86.90 / $119.73	Professional		$64.37	$86.90	$119.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $41.66 / $58.03	Professional	26	$34.90	$41.66	$58.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.60 / $48.45 / $67.48	Professional	TC	$40.60	$48.45	$67.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $61.76 / $119.18	Professional		$36.40	$61.76	$119.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.29 / $81.37 / $140.28	Professional		$57.29	$81.37	$140.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.91 / $41.95 / $67.00	Professional	26	$30.91	$41.95	$67.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $34.38 / $56.89	Professional	TC	$20.41	$34.38	$56.89
United Facility/Professional Professional Modifier Low / Median / High Price $42.61 / $58.21 / $94.35	Professional		$42.61	$58.21	$94.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.90 / $34.46 / $55.56	Professional	26	$24.90	$34.46	$55.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.80 / $24.54 / $40.88	Professional	TC	$15.80	$24.54	$40.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.94 / $61.97 / $87.45	Professional		$54.94	$61.97	$87.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.40 / $29.27 / $40.46	Professional	26	$25.40	$29.27	$40.46
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.54 / $32.70 / $46.99	Professional	TC	$29.54	$32.70	$46.99