Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.69 / $29.15 / $51.17	Facility	26	$23.69	$29.15	$51.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.17 / $72.65 / $116.31	Professional		$55.17	$72.65	$116.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $39.46 / $62.72	Professional	26	$29.15	$39.46	$62.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.49 / $32.75 / $52.42	Professional	TC	$22.49	$32.75	$52.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.33 / $66.12 / $80.01	Professional		$63.33	$66.12	$80.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $34.74 / $50.60	Professional	26	$31.36	$34.74	$50.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $56.29 / $99.12	Professional		$28.91	$56.29	$99.12
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $105.79 / $112.01	Professional		$76.04	$105.79	$112.01
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $50.94 / $50.94	Professional	26	$34.97	$50.94	$50.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.12 / $88.74 / $140.49	Professional		$66.12	$88.74	$140.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $52.11 / $87.87	Professional	26	$36.79	$52.11	$87.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $36.15 / $61.26	Professional	TC	$23.35	$36.15	$61.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.68 / $139.32 / $176.34	Facility	26	$83.68	$139.32	$176.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $568.04 / $568.04 / $586.04	Professional		$568.04	$568.04	$586.04
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $234.92 / $234.92 / $285.00	Professional	26	$234.92	$234.92	$285.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.63 / $244.63 / $301.05	Professional	TC	$244.63	$244.63	$301.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.86 / $96.00 / $133.71	Professional		$78.86	$96.00	$133.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $48.01 / $66.87	Professional	26	$40.22	$48.01	$66.87
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 $39.40 / $64.59 / $127.42	Professional		$39.40	$64.59	$127.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $91.37 / $158.68	Professional		$68.16	$91.37	$158.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $51.78 / $86.21	Professional	26	$36.79	$51.78	$86.21
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.13 / $35.82 / $58.67	Professional	TC	$23.13	$35.82	$58.67
United Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $67.48 / $106.63	Professional		$50.62	$67.48	$106.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $43.16 / $69.87	Professional	26	$30.70	$43.16	$69.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $25.40 / $42.86	Professional	TC	$17.32	$25.40	$42.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $66.12 / $93.12	Professional		$29.27	$66.12	$93.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $35.04 / $47.22	Professional	26	$33.72	$35.04	$47.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $34.52 / $46.56	Professional	TC	$32.40	$34.52	$46.56