Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.04 / $36.49 / $59.09	Facility	26	$27.04	$36.49	$59.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.83 / $83.98 / $121.85	Professional		$58.83	$83.98	$121.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $44.48 / $71.37	Professional	26	$33.22	$44.48	$71.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $39.61 / $62.31	Professional	TC	$26.17	$39.61	$62.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.70 / $93.94 / $100.21	Professional		$84.70	$93.94	$100.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.49 / $38.49 / $38.49	Professional	26	$38.49	$38.49	$38.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $67.73 / $115.49	Professional		$36.00	$67.73	$115.49
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $88.55 / $123.20 / $130.35	Professional		$88.55	$123.20	$130.35
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $38.82 / $40.24	Professional	26	$38.82	$38.82	$40.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.06 / $101.05 / $163.19	Professional		$74.06	$101.05	$163.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.12 / $57.39 / $97.50	Professional	26	$41.12	$57.39	$97.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.12 / $42.74 / $72.80	Professional	TC	$27.12	$42.74	$72.80
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.51 / $159.01 / $204.09	Facility	26	$95.51	$159.01	$204.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $676.25 / $676.25 / $682.65	Professional		$676.25	$676.25	$682.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $271.97 / $271.97 / $324.98	Professional	26	$271.97	$271.97	$324.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $290.20 / $290.20 / $357.60	Professional	TC	$290.20	$290.20	$357.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.89 / $111.86 / $155.81	Professional		$91.89	$111.86	$155.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.91 / $54.80 / $76.31	Professional	26	$45.91	$54.80	$76.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.81 / $57.06 / $79.48	Professional	TC	$47.81	$57.06	$79.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.66 / $75.31 / $148.10	Professional		$45.66	$75.31	$148.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.54 / $103.89 / $184.42	Professional		$76.54	$103.89	$184.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.15 / $56.46 / $90.47	Professional	26	$41.15	$56.46	$90.47
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $42.24 / $69.75	Professional	TC	$27.05	$42.24	$69.75
United Facility/Professional Professional Modifier Low / Median / High Price $57.05 / $76.98 / $120.99	Professional		$57.05	$76.98	$120.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.04 / $46.24 / $75.62	Professional	26	$35.04	$46.24	$75.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.27 / $29.36 / $50.79	Professional	TC	$20.27	$29.36	$50.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $68.19 / $77.00 / $108.54	Professional		$68.19	$77.00	$108.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $38.49 / $53.19	Professional	26	$33.40	$38.49	$53.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.79 / $38.51 / $55.35	Professional	TC	$34.79	$38.51	$55.35