Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.94 / $11.18 / $17.89	Facility	26	$8.94	$11.18	$17.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.19 / $92.27 / $181.05	Professional		$66.19	$92.27	$181.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $12.22 / $25.68	Professional	26	$8.94	$12.22	$25.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.10 / $41.17 / $145.60	Professional	52	$33.10	$41.17	$145.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.79 / $75.11 / $131.53	Professional	TC	$54.79	$75.11	$131.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.72 / $75.31 / $97.92	Professional		$52.72	$75.31	$97.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.13 / $18.36	Professional	26	$8.66	$11.13	$18.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.35 / $54.56 / $64.18	Professional	TC	$51.35	$54.56	$64.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.44 / $58.35 / $111.86	Professional		$10.44	$58.35	$111.86
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $97.92 / $146.03	Professional		$75.31	$97.92	$146.03
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.02 / $11.65 / $11.65	Professional	26	$11.02	$11.65	$11.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $114.14 / $191.34	Professional		$76.59	$114.14	$191.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $15.55 / $26.28	Professional	26	$11.64	$15.55	$26.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.13 / $97.88 / $168.89	Professional	TC	$68.13	$97.88	$168.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $97.26 / $125.86 / $125.86	Facility	26	$97.26	$125.86	$125.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $692.85 / $768.54 / $789.60	Professional		$692.85	$768.54	$789.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $267.48 / $267.48 / $267.48	Professional	26	$267.48	$267.48	$267.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $596.40 / $698.48 / $717.62	Professional	TC	$596.40	$698.48	$717.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $20.21 / $114.61 / $186.54	Professional		$20.21	$114.61	$186.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $18.11 / $27.41	Professional	26	$14.15	$18.11	$27.41
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $26.96 / $26.96 / $26.96	Professional	52	$26.96	$26.96	$26.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.91 / $108.69 / $159.13	Professional	TC	$84.91	$108.69	$159.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.84 / $75.31 / $139.04	Professional		$11.84	$75.31	$139.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $116.31 / $211.35	Professional		$77.81	$116.31	$211.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $15.55 / $23.75	Professional	26	$11.59	$15.55	$23.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $68.39 / $97.48 / $167.00	Professional	TC	$68.39	$97.48	$167.00
United Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $99.64 / $170.38	Professional		$71.53	$99.64	$170.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $13.64 / $22.08	Professional	26	$10.14	$13.64	$22.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.15 / $86.26 / $151.81	Professional	TC	$62.15	$86.26	$151.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.64 / $75.31 / $107.50	Professional		$67.64	$75.31	$107.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.13 / $15.58	Professional	26	$9.66	$11.13	$15.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $57.98 / $64.18 / $92.23	Professional	TC	$57.98	$64.18	$92.23