Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.73 / $14.34 / $25.34	Facility	26	$11.73	$14.34	$25.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.77 / $47.22 / $75.94	Professional		$33.77	$47.22	$75.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $19.18 / $29.98	Professional	26	$14.34	$19.18	$29.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $28.67 / $45.65	Professional	TC	$16.44	$28.67	$45.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $46.05 / $62.19	Professional		$43.82	$46.05	$62.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $16.55 / $20.19	Professional	26	$14.07	$16.55	$20.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.19 / $35.34 / $67.75	Professional		$14.19	$35.34	$67.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $75.84 / $75.84 / $75.84	Professional		$75.84	$75.84	$75.84
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $25.22 / $25.22	Professional	26	$17.17	$25.22	$25.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.42 / $56.54 / $93.72	Professional		$40.42	$56.54	$93.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $25.68 / $45.51	Professional	26	$17.98	$25.68	$45.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $29.98 / $51.68	Professional	TC	$17.41	$29.98	$51.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.24 / $80.00 / $98.31	Facility	26	$41.24	$80.00	$98.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $351.65 / $351.65 / $400.65	Professional		$351.65	$351.65	$400.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.37 / $131.37 / $139.19	Professional	26	$131.37	$131.37	$139.19
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $214.27 / $214.27 / $261.45	Professional	TC	$214.27	$214.27	$261.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.57 / $62.88 / $86.64	Professional		$53.57	$62.88	$86.64
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $23.55 / $38.69	Professional	26	$19.73	$23.55	$38.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.20 / $44.64 / $69.87	Professional	TC	$37.20	$44.64	$69.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $49.14 / $86.30	Professional		$21.25	$49.14	$86.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.32 / $58.39 / $102.44	Professional		$41.32	$58.39	$102.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $25.46 / $41.62	Professional	26	$17.98	$25.46	$41.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $29.45 / $48.45	Professional	TC	$17.14	$29.45	$48.45
United Facility/Professional Professional Modifier Low / Median / High Price $30.82 / $42.00 / $69.00	Professional		$30.82	$42.00	$69.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $21.04 / $34.79	Professional	26	$15.30	$21.04	$34.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.21 / $21.17 / $34.86	Professional	TC	$13.21	$21.17	$34.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $44.67 / $63.27	Professional		$39.75	$44.67	$63.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $16.55 / $22.87	Professional	26	$14.36	$16.55	$22.87
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $28.12 / $40.40	Professional	TC	$25.40	$28.12	$40.40