Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.40 / $46.88 / $80.09	Facility	26	$36.40	$46.88	$80.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.28 / $98.38 / $172.23	Professional		$70.28	$98.38	$172.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.61 / $58.30 / $101.40	Professional	26	$44.61	$58.30	$101.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $38.60 / $61.79	Professional	TC	$26.78	$38.60	$61.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $95.79 / $125.18	Professional		$88.19	$95.79	$125.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.35 / $52.16 / $101.16	Professional	26	$50.35	$52.16	$101.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.17 / $78.97 / $134.13	Professional		$44.17	$78.97	$134.13
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $99.34 / $126.52 / $196.05	Professional		$99.34	$126.52	$196.05
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $53.71 / $53.78	Professional	26	$53.71	$53.71	$53.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.36 / $118.93 / $193.81	Professional		$87.36	$118.93	$193.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.33 / $75.31 / $122.74	Professional	26	$55.33	$75.31	$122.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.80 / $42.72 / $72.03	Professional	TC	$27.80	$42.72	$72.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $129.41 / $248.27 / $270.89	Facility	26	$129.41	$248.27	$270.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $746.58 / $746.58 / $795.23	Professional		$746.58	$746.58	$795.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $352.29 / $352.29 / $440.48	Professional	26	$352.29	$352.29	$440.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.04 / $288.04 / $354.75	Professional	TC	$288.04	$288.04	$354.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $130.87 / $182.29	Professional		$107.50	$130.87	$182.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.23 / $74.27 / $103.45	Professional	26	$62.23	$74.27	$103.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.42 / $56.60 / $75.20	Professional	TC	$47.42	$56.60	$75.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $95.29 / $173.20	Professional		$50.30	$95.29	$173.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.37 / $122.28 / $215.34	Professional		$90.37	$122.28	$215.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $55.33 / $74.29 / $117.89	Professional	26	$55.33	$74.29	$117.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.75 / $42.41 / $69.17	Professional	TC	$27.75	$42.41	$69.17
United Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $91.55 / $144.97	Professional		$68.34	$91.55	$144.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.74 / $61.28 / $98.13	Professional	26	$45.74	$61.28	$98.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $30.40 / $50.67	Professional	TC	$20.39	$30.40	$50.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.78 / $90.37 / $126.99	Professional		$79.78	$90.37	$126.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $52.16 / $72.09	Professional	26	$45.28	$52.16	$72.09
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.51 / $38.21 / $54.90	Professional	TC	$34.51	$38.21	$54.90