Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.41 / $16.47 / $28.97	Facility	26	$13.41	$16.47	$28.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $54.37 / $80.00	Professional		$38.35	$54.37	$80.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $21.43 / $34.99	Professional	26	$16.23	$21.43	$34.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.23 / $32.46 / $51.90	Professional	TC	$18.23	$32.46	$51.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $59.22 / $67.64	Professional		$51.50	$59.22	$67.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $19.10 / $22.71	Professional	26	$16.23	$19.10	$22.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $41.43 / $76.84	Professional		$17.55	$41.43	$76.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $82.40 / $110.88	Professional		$51.50	$82.40	$110.88
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $19.27 / $19.27 / $19.82	Professional	26	$19.27	$19.27	$19.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.57 / $62.41 / $104.92	Professional		$43.57	$62.41	$104.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $27.90 / $46.72	Professional	26	$20.32	$27.90	$46.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $34.00 / $59.20	Professional	TC	$19.11	$34.00	$59.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.70 / $97.62 / $99.28	Facility	26	$47.70	$97.62	$99.28
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $378.70 / $378.70 / $461.40	Professional		$378.70	$378.70	$461.40
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.11 / $130.11 / $160.35	Professional	26	$130.11	$130.11	$160.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $242.47 / $242.47 / $301.05	Professional	TC	$242.47	$242.47	$301.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.14 / $75.18 / $104.72	Professional		$60.14	$75.18	$104.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.77 / $27.17 / $46.44	Professional	26	$22.77	$27.17	$46.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $48.01 / $66.87	Professional	TC	$40.22	$48.01	$66.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.46 / $54.85 / $99.29	Professional		$24.46	$54.85	$99.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $64.50 / $116.19	Professional		$44.27	$64.50	$116.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $27.78 / $44.37	Professional	26	$20.32	$27.78	$44.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $33.33 / $53.85	Professional	TC	$19.00	$33.33	$53.85
United Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $45.60 / $74.94	Professional		$33.35	$45.60	$74.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $22.73 / $36.79	Professional	26	$16.72	$22.73	$36.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $23.64 / $39.90	Professional	TC	$14.50	$23.64	$39.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $51.50 / $72.95	Professional		$45.83	$51.50	$72.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $19.10 / $26.41	Professional	26	$16.57	$19.10	$26.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.27 / $32.40 / $46.56	Professional	TC	$29.27	$32.40	$46.56