Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.91 / $39.81	Facility	26	$19.95	$22.91	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $107.15	Professional		$42.66	$60.26	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.92 / $64.57	Professional	26	$20.89	$26.92	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $33.11 / $50.12	Professional	TC	$16.98	$33.11	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $75.86	Professional		$50.12	$66.07	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $27.54 / $40.74	Professional	26	$23.44	$27.54	$40.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $46.77 / $85.11	Professional		$22.91	$46.77	$85.11
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $35.48 / $35.48	Professional	26	$24.55	$35.48	$35.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	26	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $117.49	Professional		$48.98	$67.61	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $34.67 / $58.88	Professional	26	$25.12	$34.67	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $32.36 / $60.26	Professional	TC	$18.62	$32.36	$60.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $489.78 / $489.78	Professional		$398.11	$489.78	$489.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $199.53 / $199.53	Professional	26	$158.49	$199.53	$199.53
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $288.40 / $288.40	Professional	TC	$239.88	$288.40	$288.40
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $20.89 / $25.12	Facility	26	$15.85	$20.89	$25.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $112.20	Professional		$43.65	$64.57	$112.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.84 / $52.48	Professional	26	$20.89	$28.84	$52.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $37.15 / $63.10	Professional	TC	$17.38	$37.15	$63.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $48.98	Professional		$32.36	$33.11	$48.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $60.26 / $117.49	Professional		$26.92	$60.26	$117.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $120.23	Professional		$48.98	$67.61	$120.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $34.67 / $54.95	Professional	26	$25.12	$34.67	$54.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $31.62 / $56.23	Professional	TC	$18.62	$31.62	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.48 / $87.10	Professional		$38.02	$52.48	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.84 / $47.86	Professional	26	$21.38	$28.84	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $24.55 / $40.74	Professional	TC	$14.79	$24.55	$40.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $60.26 / $70.79	Professional		$57.54	$60.26	$70.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.12 / $30.90	Professional	26	$24.55	$25.12	$30.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $34.67 / $40.74	Professional	TC	$32.36	$34.67	$40.74