Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.00 / $2.75 / $4.41	Facility	26	$2.00	$2.75	$4.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.22 / $37.20 / $114.60	Professional		$19.22	$37.20	$114.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.47 / $3.73 / $13.59	Professional	26	$2.47	$3.73	$13.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.14 / $11.54 / $20.21	Professional	52	$8.14	$11.54	$20.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.37 / $23.49 / $51.13	Professional	TC	$15.37	$23.49	$51.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $22.86 / $43.61	Professional		$16.73	$22.86	$43.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.02 / $2.94 / $3.74	Professional	26	$2.02	$2.94	$3.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.58 / $16.60 / $31.99	Professional		$2.58	$16.60	$31.99
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $30.80 / $76.97	Professional		$20.91	$30.80	$76.97
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $2.84 / $3.15 / $3.31	Professional	26	$2.84	$3.15	$3.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.56 / $34.14 / $117.86	Professional		$23.56	$34.14	$117.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $4.43 / $7.39	Professional	26	$3.24	$4.43	$7.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.24 / $29.31 / $90.75	Professional	TC	$21.24	$29.31	$90.75
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $101.15 / $101.15	Facility	26	$100.00	$101.15	$101.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $572.89 / $724.06 / $724.06	Professional		$572.89	$724.06	$724.06
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $175.02 / $289.41 / $289.41	Professional	26	$175.02	$289.41	$289.41
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $660.75 / $680.57 / $680.57	Professional	TC	$660.75	$680.57	$680.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $5.18 / $29.70 / $88.00	Professional		$5.18	$29.70	$88.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.64 / $4.66 / $6.84	Professional	26	$3.64	$4.66	$6.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.85 / $30.53 / $47.21	Professional	TC	$23.85	$30.53	$47.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.62 / $23.58 / $41.10	Professional		$3.62	$23.58	$41.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.19 / $34.31 / $84.67	Professional		$23.19	$34.31	$84.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $4.38 / $6.95	Professional	26	$3.24	$4.38	$6.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $28.77 / $69.33	Professional	TC	$21.06	$28.77	$69.33
United Facility/Professional Professional Modifier Low / Median / High Price $20.62 / $29.05 / $99.84	Professional		$20.62	$29.05	$99.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.61 / $3.67 / $6.30	Professional	26	$2.61	$3.67	$6.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.04 / $25.31 / $93.06	Professional	TC	$18.04	$25.31	$93.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.78 / $20.91 / $29.92	Professional		$18.78	$20.91	$29.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.48 / $2.88 / $4.03	Professional	26	$2.48	$2.88	$4.03
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.28 / $18.03 / $25.95	Professional	TC	$16.28	$18.03	$25.95