Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.58 / $6.34 / $10.23	Facility	26	$4.58	$6.34	$10.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.55 / $29.92 / $116.00	Professional		$20.55	$29.92	$116.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.66 / $8.16 / $33.61	Professional	26	$5.66	$8.16	$33.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.09 / $20.04 / $34.14	Professional	TC	$13.09	$20.04	$34.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.30 / $27.82 / $46.56	Professional		$18.30	$27.82	$46.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $6.82 / $8.18	Professional	26	$4.68	$6.82	$8.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $17.79 / $34.10	Professional		$5.62	$17.79	$34.10
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $32.28 / $38.95	Professional		$25.17	$32.28	$38.95
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $6.74 / $7.25	Professional	26	$6.61	$6.74	$7.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $8.11 / $8.11	Facility	26	$8.11	$8.11	$8.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $35.89 / $68.40	Professional		$25.59	$35.89	$68.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.35 / $9.93 / $16.09	Professional	26	$7.35	$9.93	$16.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.18 / $25.84 / $51.79	Professional	TC	$19.18	$25.84	$51.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.83 / $103.69 / $103.69	Facility	26	$33.83	$103.69	$103.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $644.00 / $644.00 / $644.00	Professional		$644.00	$644.00	$644.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $148.60 / $228.88 / $228.88	Professional	26	$148.60	$228.88	$228.88
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $542.00 / $542.00 / $542.00	Professional	TC	$542.00	$542.00	$542.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $12.43 / $35.90 / $95.76	Professional		$12.43	$35.90	$95.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $10.86 / $15.99	Professional	26	$8.49	$10.86	$15.99
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $27.42 / $41.89	Professional	TC	$20.11	$27.42	$41.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $23.34 / $44.10	Professional		$7.85	$23.34	$44.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $8.11 / $8.11	Facility	26	$8.11	$8.11	$8.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.27 / $36.50 / $68.29	Professional		$25.27	$36.50	$68.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.35 / $9.83 / $15.17	Professional	26	$7.35	$9.83	$15.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.91 / $25.39 / $47.04	Professional	TC	$18.91	$25.39	$47.04
United Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $30.89 / $62.55	Professional		$21.66	$30.89	$62.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.07 / $8.34 / $13.79	Professional	26	$6.07	$8.34	$13.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $22.57 / $47.30	Professional	TC	$15.59	$22.57	$47.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.43 / $22.88 / $32.51	Professional		$20.43	$22.88	$32.51
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $6.68 / $9.35	Professional	26	$5.80	$6.68	$9.35
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.63 / $16.20 / $23.30	Professional	TC	$14.63	$16.20	$23.30