Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.89 / $22.04 / $38.65	Facility	26	$17.89	$22.04	$38.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.75 / $137.76 / $226.70	Professional		$101.75	$137.76	$226.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $22.48 / $37.61	Professional	26	$18.60	$22.48	$37.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.80 / $108.07 / $204.06	Professional	TC	$81.80	$108.07	$204.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $96.39 / $121.56	Professional		$79.34	$96.39	$121.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $36.22 / $40.83	Professional	26	$20.07	$36.22	$40.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $90.77 / $196.23	Professional		$21.46	$90.77	$196.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $101.16 / $166.68 / $221.54	Professional		$101.16	$166.68	$221.54
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $21.52 / $23.05	Professional	26	$21.52	$21.52	$23.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.83 / $172.44 / $299.01	Professional		$118.83	$172.44	$299.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $28.44 / $46.20	Professional	26	$21.15	$28.44	$46.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.53 / $141.77 / $262.19	Professional	TC	$97.53	$141.77	$262.19
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $76.12 / $174.32 / $174.32	Facility	26	$76.12	$174.32	$174.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,035.17 / $1,037.03 / $1,063.54	Professional		$1,035.17	$1,037.03	$1,063.54
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $303.79 / $303.79 / $303.79	Professional	26	$303.79	$303.79	$303.79
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $848.18 / $922.24 / $947.51	Professional	TC	$848.18	$922.24	$947.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $113.35 / $176.15 / $386.88	Professional		$113.35	$176.15	$386.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.90 / $35.71 / $54.82	Professional	26	$27.90	$35.71	$54.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.90 / $154.75 / $232.23	Professional	TC	$120.90	$154.75	$232.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $117.09 / $195.60	Professional		$25.25	$117.09	$195.60
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.83 / $177.55 / $319.20	Professional		$119.83	$177.55	$319.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $28.00 / $43.93	Professional	26	$21.46	$28.00	$43.93
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $97.27 / $140.00 / $254.77	Professional	TC	$97.27	$140.00	$254.77
United Facility/Professional Professional Modifier Low / Median / High Price $105.10 / $154.36 / $257.27	Professional		$105.10	$154.36	$257.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.07 / $25.98 / $41.75	Professional	26	$19.07	$25.98	$41.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.31 / $126.46 / $214.04	Professional	TC	$84.31	$126.46	$214.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $113.35 / $161.51	Professional		$101.60	$113.35	$161.51
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.96 / $30.74	Professional	26	$19.05	$21.96	$30.74
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $82.55 / $91.39 / $131.37	Professional	TC	$82.55	$91.39	$131.37