Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.02 / $22.08 / $38.92	Facility	26	$18.02	$22.08	$38.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.93 / $165.59 / $335.34	Professional		$127.93	$165.59	$335.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $23.94 / $37.14	Professional	26	$19.41	$23.94	$37.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.52 / $141.82 / $263.70	Professional	TC	$108.52	$141.82	$263.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.67 / $108.57 / $108.57	Professional		$102.67	$108.57	$108.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $24.44 / $24.44	Professional	26	$17.82	$24.44	$24.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $115.17 / $246.57	Professional		$21.46	$115.17	$246.57
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $120.00	Professional		$120.00	$120.00	$120.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $32.97 / $32.97	Professional	26	$22.04	$32.97	$32.97
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 $149.60 / $218.42 / $373.29	Professional		$149.60	$218.42	$373.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $31.07 / $51.64	Professional	26	$23.37	$31.07	$51.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.54 / $187.30 / $330.57	Professional	TC	$131.54	$187.30	$330.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $236.27 / $236.27	Facility	26	$100.00	$236.27	$236.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,346.55 / $1,431.47 / $1,470.69	Professional		$1,346.55	$1,431.47	$1,470.69
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $293.89 / $293.89 / $293.89	Professional	26	$293.89	$293.89	$293.89
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,154.84 / $1,288.22 / $1,323.51	Professional	TC	$1,154.84	$1,288.22	$1,323.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $146.66 / $231.44 / $360.91	Professional		$146.66	$231.44	$360.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $36.22 / $54.82	Professional	26	$26.56	$36.22	$54.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.43 / $210.64 / $306.08	Professional	TC	$154.43	$210.64	$306.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.51 / $141.10 / $292.87	Professional		$23.51	$141.10	$292.87
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 $150.84 / $224.09 / $402.11	Professional		$150.84	$224.09	$402.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $31.01 / $48.04	Professional	26	$23.34	$31.01	$48.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $132.44 / $187.25 / $316.01	Professional	TC	$132.44	$187.25	$316.01
United Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $191.74 / $327.85	Professional		$133.38	$191.74	$327.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $26.53 / $43.57	Professional	26	$20.05	$26.53	$43.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.60 / $164.53 / $282.94	Professional	TC	$117.60	$164.53	$282.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.68 / $146.66 / $209.39	Professional		$131.68	$146.66	$209.39
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $22.27 / $31.18	Professional	26	$19.32	$22.27	$31.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $112.36 / $124.40 / $178.81	Professional	TC	$112.36	$124.40	$178.81