Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.73 / $21.54 / $38.32	Facility	26	$17.73	$21.54	$38.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.26 / $123.07 / $222.42	Professional		$101.26	$123.07	$222.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $22.11 / $40.28	Professional	26	$14.49	$22.11	$40.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.07 / $102.26 / $172.15	Professional	TC	$82.07	$102.26	$172.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $95.75 / $137.66	Professional		$78.93	$95.75	$137.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $22.05 / $40.15	Professional	26	$17.32	$22.05	$40.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.55 / $90.28 / $193.29	Professional		$20.55	$90.28	$193.29
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $169.13 / $364.58	Professional		$74.00	$169.13	$364.58
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.43 / $32.97 / $32.97	Professional	26	$21.43	$32.97	$32.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $172.59 / $283.43	Professional		$118.41	$172.59	$283.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $25.75 / $44.35	Professional	26	$17.76	$25.75	$44.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.36 / $145.41 / $254.60	Professional	TC	$97.36	$145.41	$254.60
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.56 / $109.96 / $109.96	Facility	26	$53.56	$109.96	$109.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,021.59 / $1,030.20 / $1,049.58	Professional		$1,021.59	$1,030.20	$1,049.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $203.09 / $203.09 / $203.09	Professional	26	$203.09	$203.09	$203.09
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $845.33 / $934.78 / $960.39	Professional	TC	$845.33	$934.78	$960.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $173.66 / $284.77	Professional		$36.07	$173.66	$284.77
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.81 / $35.20 / $53.31	Professional	26	$25.81	$35.20	$53.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $113.07 / $154.22 / $231.46	Professional	TC	$113.07	$154.22	$231.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.99 / $108.84 / $158.26	Professional		$25.99	$108.84	$158.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.71 / $175.35 / $312.26	Professional		$119.71	$175.35	$312.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $25.58 / $41.06	Professional	26	$17.76	$25.58	$41.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $97.36 / $144.21 / $253.19	Professional	TC	$97.36	$144.21	$253.19
United Facility/Professional Professional Modifier Low / Median / High Price $105.10 / $153.31 / $257.27	Professional		$105.10	$153.31	$257.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $23.99 / $38.57	Professional	26	$15.01	$23.99	$38.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.89 / $126.61 / $214.39	Professional	TC	$84.89	$126.61	$214.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $112.75 / $160.69	Professional		$101.04	$112.75	$160.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $21.66 / $30.32	Professional	26	$18.78	$21.66	$30.32
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $82.27 / $91.08 / $130.91	Professional	TC	$82.27	$91.08	$130.91