Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.50 / $15.80 / $25.42	Facility	26	$11.50	$15.80	$25.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.37 / $64.27 / $204.33	Professional		$41.37	$64.27	$204.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $20.02 / $71.00	Professional	26	$14.07	$20.02	$71.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.94 / $37.68 / $69.20	Professional	TC	$23.94	$37.68	$69.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $39.54 / $63.08	Professional		$32.56	$39.54	$63.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $16.95 / $21.54	Professional	26	$11.60	$16.95	$21.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.43 / $35.82 / $68.66	Professional		$14.43	$35.82	$68.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $63.08 / $90.00	Professional		$48.82	$63.08	$90.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $17.98 / $17.98	Professional	26	$16.39	$17.98	$17.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.10 / $20.10 / $20.10	Facility	26	$20.10	$20.10	$20.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.52 / $72.51 / $132.47	Professional		$51.52	$72.51	$132.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.26 / $24.59 / $39.93	Professional	26	$18.26	$24.59	$39.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.06 / $47.21 / $90.32	Professional	TC	$35.06	$47.21	$90.32
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $88.80 / $128.36 / $128.36	Facility	26	$88.80	$128.36	$128.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $437.57 / $604.11 / $624.04	Professional		$437.57	$604.11	$624.04
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.01 / $456.30 / $456.30	Professional	26	$246.01	$456.30	$456.30
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $388.70 / $400.36 / $400.36	Professional	TC	$388.70	$400.36	$400.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $67.28 / $134.13	Professional		$27.59	$67.28	$134.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $27.75 / $63.08	Professional	26	$21.03	$27.75	$63.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.63 / $50.72 / $76.91	Professional	TC	$39.63	$50.72	$76.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $45.82 / $88.31	Professional		$19.14	$45.82	$88.31
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.10 / $20.10 / $20.10	Facility	26	$20.10	$20.10	$20.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.93 / $72.78 / $133.30	Professional		$50.93	$72.78	$133.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $24.45 / $37.36	Professional	26	$17.98	$24.45	$37.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $45.95 / $86.35	Professional	TC	$34.97	$45.95	$86.35
United Facility/Professional Professional Modifier Low / Median / High Price $43.30 / $61.39 / $120.41	Professional		$43.30	$61.39	$120.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $19.89 / $33.14	Professional	26	$14.98	$19.89	$33.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.58 / $41.09 / $90.16	Professional	TC	$28.58	$41.09	$90.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $46.52 / $65.91	Professional		$41.41	$46.52	$65.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $16.57 / $23.20	Professional	26	$14.36	$16.57	$23.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $29.95 / $43.04	Professional	TC	$27.05	$29.95	$43.04