Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.53 / $20.78 / $35.70	Facility	26	$16.53	$20.78	$35.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $58.42 / $85.96	Professional		$41.03	$58.42	$85.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $26.32 / $41.54	Professional	26	$20.27	$26.32	$41.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $31.88 / $50.85	Professional	TC	$17.87	$31.88	$50.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $66.33 / $76.14	Professional		$50.88	$66.33	$76.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.72 / $28.72 / $28.72	Professional	26	$28.72	$28.72	$28.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.67 / $46.75 / $86.26	Professional		$22.67	$46.75	$86.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $87.54 / $92.86	Professional		$62.92	$87.54	$92.86
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $35.69 / $35.69	Professional	26	$24.73	$35.69	$35.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $68.05 / $114.53	Professional		$49.03	$68.05	$114.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.03 / $34.34 / $58.00	Professional	26	$25.03	$34.34	$58.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.04 / $33.22 / $57.69	Professional	TC	$19.04	$33.22	$57.69
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $58.37 / $118.83 / $122.08	Facility	26	$58.37	$118.83	$122.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $398.18 / $398.18 / $488.70	Professional		$398.18	$398.18	$488.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $160.04 / $160.04 / $198.98	Professional	26	$160.04	$160.04	$198.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $238.14 / $238.14 / $289.73	Professional	TC	$238.14	$238.14	$289.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $65.47 / $79.70 / $111.01	Professional		$65.47	$79.70	$111.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $33.52 / $46.68	Professional	26	$28.08	$33.52	$46.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.70 / $46.19 / $64.33	Professional	TC	$38.70	$46.19	$64.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $58.13 / $105.95	Professional		$30.24	$58.13	$105.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.26 / $70.50 / $125.13	Professional		$49.26	$70.50	$125.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.04 / $34.14 / $54.38	Professional	26	$25.04	$34.14	$54.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $32.45 / $52.82	Professional	TC	$18.72	$32.45	$52.82
United Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $51.51 / $81.96	Professional		$37.00	$51.51	$81.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $28.38 / $44.60	Professional	26	$20.30	$28.38	$44.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $23.46 / $39.07	Professional	TC	$14.50	$23.46	$39.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.59 / $54.71 / $77.31	Professional		$48.59	$54.71	$77.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $23.54 / $32.52	Professional	26	$20.43	$23.54	$32.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $31.18 / $44.79	Professional	TC	$28.16	$31.18	$44.79