Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.74 / $10.02 / $14.07	Facility	26	$7.74	$10.02	$14.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $46.49 / $94.65	Professional		$35.51	$46.49	$94.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $90.40 / $90.40 / $90.40	Professional	25	$90.40	$90.40	$90.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $11.45 / $25.82	Professional	26	$9.27	$11.45	$25.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.85 / $31.89 / $54.60	Professional	TC	$24.85	$31.89	$54.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $37.21 / $57.57	Professional		$32.14	$37.21	$57.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $11.05 / $12.97	Professional	26	$8.69	$11.05	$12.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.84 / $24.23 / $25.81	Professional	TC	$22.84	$24.23	$25.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.65 / $27.28 / $52.29	Professional		$8.65	$27.28	$52.29
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $35.34 / $48.80 / $91.08	Professional		$35.34	$48.80	$91.08
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $13.07 / $13.07	Professional	26	$10.22	$13.07	$13.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.21 / $68.39 / $106.14	Professional		$40.21	$68.39	$106.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $15.68 / $25.77	Professional	26	$10.44	$15.68	$25.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.78 / $52.29 / $80.79	Professional	TC	$29.78	$52.29	$80.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.82 / $100.00 / $100.00	Facility	26	$23.82	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $632.00 / $632.00 / $632.00	Professional		$632.00	$632.00	$632.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $223.21 / $229.91 / $229.91	Professional	26	$223.21	$229.91	$229.91
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $247.28 / $259.02 / $266.13	Professional	TC	$247.28	$259.02	$266.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $52.99 / $89.00	Professional		$18.16	$52.99	$89.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $13.58 / $18.04	Professional	26	$11.16	$13.58	$18.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $39.40 / $52.34	Professional	TC	$32.36	$39.40	$52.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.31 / $34.03 / $56.79	Professional		$10.31	$34.03	$56.79
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.12 / $72.78 / $110.22	Professional		$42.12	$72.78	$110.22
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $15.49 / $25.37	Professional	26	$10.54	$15.49	$25.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.98 / $52.85 / $82.32	Professional	TC	$29.98	$52.85	$82.32
United Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $61.24 / $94.86	Professional		$45.41	$61.24	$94.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $13.68 / $21.59	Professional	26	$10.01	$13.68	$21.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.19 / $48.33 / $73.81	Professional	TC	$35.19	$48.33	$73.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $36.15 / $51.37	Professional		$32.29	$36.15	$51.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $9.56 / $13.18	Professional	26	$8.27	$9.56	$13.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $26.59 / $38.21	Professional	TC	$24.02	$26.59	$38.21