Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.04 / $34.00 / $58.41	Facility	26	$27.04	$34.00	$58.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.22 / $79.83 / $129.29	Professional		$54.22	$79.83	$129.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $43.11 / $66.15	Professional	26	$33.22	$43.11	$66.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.21 / $35.36 / $56.58	Professional	TC	$23.21	$35.36	$56.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $75.53 / $92.84	Professional		$62.33	$75.53	$92.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.04 / $63.56	Professional	26	$37.15	$44.04	$63.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $66.48 / $110.04	Professional		$36.00	$66.48	$110.04
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $84.33 / $117.33 / $124.08	Professional		$84.33	$117.33	$124.08
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.92 / $58.10 / $58.10	Professional	26	$39.92	$58.10	$58.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.34 / $95.98 / $155.63	Professional		$69.34	$95.98	$155.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.07 / $55.65 / $93.76	Professional	26	$41.07	$55.65	$93.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.22 / $38.42 / $65.88	Professional	TC	$24.22	$38.42	$65.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.51 / $190.77 / $199.79	Facility	26	$95.51	$190.77	$199.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $622.15 / $622.15 / $648.67	Professional		$622.15	$622.15	$648.67
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $262.07 / $262.07 / $324.98	Professional	26	$262.07	$262.07	$324.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $264.17 / $264.17 / $323.63	Professional	TC	$264.17	$264.17	$323.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $106.41 / $153.00	Professional		$87.41	$106.41	$153.00
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 $43.26 / $51.63 / $98.81	Professional	TC	$43.26	$51.63	$98.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $72.20 / $140.65	Professional		$43.34	$72.20	$140.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.17 / $98.30 / $173.58	Professional		$72.17	$98.30	$173.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.92 / $55.41 / $86.79	Professional	26	$40.92	$55.41	$86.79
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.09 / $38.22 / $62.84	Professional	TC	$24.09	$38.22	$62.84
United Facility/Professional Professional Modifier Low / Median / High Price $53.59 / $71.89 / $116.49	Professional		$53.59	$71.89	$116.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.02 / $45.79 / $73.04	Professional	26	$33.02	$45.79	$73.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $27.65 / $46.38	Professional	TC	$18.36	$27.65	$46.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.87 / $73.33 / $103.26	Professional		$64.87	$73.33	$103.26
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 $31.48 / $34.84 / $50.07	Professional	TC	$31.48	$34.84	$50.07