Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $40.74 / $64.57	Facility	26	$33.11	$40.74	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $85.11 / $158.49	Professional		$67.61	$85.11	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $125.89	Professional	26	$33.88	$45.71	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $61.66	Professional	TC	$25.70	$39.81	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $104.71	Professional		$70.79	$85.11	$104.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $44.67 / $54.95	Professional	26	$41.69	$44.67	$54.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $69.18 / $114.82	Professional		$37.15	$69.18	$114.82
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $131.83	Professional		$89.13	$131.83	$131.83
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $39.81	Professional	26	$38.90	$38.90	$39.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $45.71 / $66.07	Facility	26	$10.00	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $169.82	Professional		$74.13	$102.33	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $57.54 / $100.00	Professional	26	$40.74	$57.54	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $77.62	Professional	TC	$26.92	$41.69	$77.62
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $323.59 / $323.59	Professional	26	$269.15	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $354.81 / $354.81	Professional	TC	$288.40	$354.81	$354.81
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $33.88 / $58.88	Facility	26	$26.92	$33.88	$58.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $158.49	Professional		$69.18	$89.13	$158.49
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $47.86 / $93.33	Professional	26	$34.67	$47.86	$93.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $45.71 / $79.43	Professional	TC	$26.30	$45.71	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $83.18 / $165.96	Professional		$40.74	$83.18	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $173.78	Professional		$74.13	$100.00	$173.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $57.54 / $91.20	Professional	26	$40.74	$57.54	$91.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $72.44	Professional	TC	$26.92	$41.69	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $131.83	Professional		$58.88	$79.43	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $47.86 / $79.43	Professional	26	$35.48	$47.86	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $51.29	Professional	TC	$20.89	$30.90	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $100.00	Professional		$79.43	$83.18	$100.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $50.12	Professional	26	$39.81	$41.69	$50.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $41.69 / $50.12	Professional	TC	$39.81	$41.69	$50.12