Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $37.15 / $64.57	Facility	26	$33.11	$37.15	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $165.96	Professional		$64.57	$85.11	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $46.77 / $114.82	Professional	26	$33.88	$46.77	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $37.15 / $56.23	Professional	TC	$22.91	$37.15	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $95.50	Professional		$69.18	$75.86	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $46.77 / $53.70	Professional	26	$39.81	$46.77	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $67.61 / $109.65	Professional		$37.15	$67.61	$109.65
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $151.36	Professional		$75.86	$114.82	$151.36
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $57.54 / $57.54	Professional	26	$39.81	$57.54	$57.54
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 $69.18 / $95.50 / $162.18	Professional		$69.18	$95.50	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $95.50	Professional	26	$40.74	$56.23	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $69.18	Professional	TC	$23.99	$38.02	$69.18
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 $616.60 / $645.65 / $645.65	Professional		$616.60	$645.65	$645.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $323.59 / $323.59	Professional	26	$263.03	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $323.59 / $323.59	Professional	TC	$263.03	$323.59	$323.59
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $33.88 / $40.74	Facility	26	$26.92	$33.88	$40.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $154.88	Professional		$66.07	$87.10	$154.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $91.20	Professional	26	$34.67	$46.77	$91.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $41.69 / $69.18	Professional	TC	$23.44	$41.69	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $81.28 / $154.88	Professional		$38.90	$81.28	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $165.96	Professional		$69.18	$95.50	$165.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $87.10	Professional	26	$40.74	$56.23	$87.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $66.07	Professional	TC	$23.99	$38.02	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $75.86 / $123.03	Professional		$54.95	$75.86	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $75.86	Professional	26	$34.67	$46.77	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $46.77	Professional	TC	$18.62	$28.18	$46.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $79.43 / $95.50	Professional		$75.86	$79.43	$95.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $48.98	Professional	26	$39.81	$40.74	$48.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $38.02 / $44.67	Professional	TC	$36.31	$38.02	$44.67