Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.36 / $32.89 / $52.78	Facility	26	$24.36	$32.89	$52.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $80.06 / $138.30	Professional		$53.78	$80.06	$138.30
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.97 / $38.88 / $71.93	Professional	26	$29.97	$38.88	$71.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $38.28 / $60.02	Professional	TC	$22.57	$38.28	$60.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.62 / $86.74 / $99.65	Professional		$56.62	$86.74	$99.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.38 / $35.58 / $42.93	Professional	26	$34.38	$35.58	$42.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.18 / $58.72 / $108.22	Professional		$29.18	$58.72	$108.22
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $97.58 / $144.56	Professional		$77.22	$97.58	$144.56
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $36.28	Professional	26	$34.67	$34.67	$36.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.93 / $91.51 / $152.69	Professional		$66.93	$91.51	$152.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $50.40 / $85.03	Professional	26	$36.79	$50.40	$85.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $40.36 / $69.72	Professional	TC	$23.70	$40.36	$69.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.71 / $174.72 / $178.60	Facility	26	$85.71	$174.72	$178.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $568.04 / $568.04 / $640.95	Professional		$568.04	$568.04	$640.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $236.22 / $236.22 / $288.98	Professional	26	$236.22	$236.22	$288.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $285.88 / $285.88 / $351.98	Professional	TC	$285.88	$285.88	$351.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $86.30 / $105.06 / $146.33	Professional		$86.30	$105.06	$146.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.97 / $48.90 / $101.30	Professional	26	$40.97	$48.90	$101.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.05 / $56.15 / $78.20	Professional	TC	$47.05	$56.15	$78.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.39 / $72.63 / $139.74	Professional		$42.39	$72.63	$139.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.42 / $95.64 / $166.04	Professional		$67.42	$95.64	$166.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.64 / $50.13 / $80.00	Professional	26	$36.64	$50.13	$80.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.37 / $39.52 / $66.37	Professional	TC	$23.37	$39.52	$66.37
United Facility/Professional Professional Modifier Low / Median / High Price $49.91 / $68.50 / $111.36	Professional		$49.91	$68.50	$111.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.78 / $41.00 / $66.23	Professional	26	$29.78	$41.00	$66.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $28.15 / $46.98	Professional	TC	$17.72	$28.15	$46.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $72.28 / $101.98	Professional		$64.04	$72.28	$101.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.81 / $34.38 / $47.51	Professional	26	$29.81	$34.38	$47.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.22 / $37.90 / $54.47	Professional	TC	$34.22	$37.90	$54.47