Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.25 / $25.38 / $35.15	Facility	26	$21.25	$25.38	$35.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.38 / $61.18 / $84.62	Professional		$50.38	$61.18	$84.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.86 / $27.78 / $39.54	Professional	26	$23.86	$27.78	$39.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $33.03 / $45.08	Professional	TC	$26.99	$33.03	$45.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $59.13 / $59.13	Professional		$5.00	$59.13	$59.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $28.12 / $34.63	Professional	26	$23.50	$28.12	$34.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $48.53 / $82.76	Professional		$24.48	$48.53	$82.76
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $73.91 / $139.05	Professional		$61.80	$73.91	$139.05
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $28.36 / $29.35	Professional	26	$25.55	$28.36	$29.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $77.90 / $150.09	Professional		$59.78	$77.90	$150.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.19 / $35.47 / $55.94	Professional	26	$27.19	$35.47	$55.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.53 / $41.11 / $69.00	Professional	TC	$31.53	$41.11	$69.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $64.69 / $122.62 / $133.05	Facility	26	$64.69	$122.62	$133.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $717.26 / $717.26 / $717.26	Professional		$717.26	$717.26	$717.26
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $330.63 / $340.55 / $340.55	Professional	26	$330.63	$340.55	$340.55
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $563.89 / $563.89 / $563.89	Professional	TC	$563.89	$563.89	$563.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.46 / $86.04 / $114.32	Professional		$61.46	$86.04	$114.32
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.13 / $37.40 / $48.73	Professional	26	$30.13	$37.40	$48.73
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.54 / $50.35 / $68.76	Professional	TC	$40.54	$50.35	$68.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.22 / $45.57 / $84.86	Professional		$28.22	$45.57	$84.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.87 / $83.70 / $156.87	Professional		$60.87	$83.70	$156.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.48 / $35.47 / $54.74	Professional	26	$27.48	$35.47	$54.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.53 / $40.97 / $62.83	Professional	TC	$31.53	$40.97	$62.83
United Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $62.33 / $97.03	Professional		$48.22	$62.33	$97.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.92 / $29.55 / $46.01	Professional	26	$22.92	$29.55	$46.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $32.59 / $51.30	Professional	TC	$24.83	$32.59	$51.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $59.13 / $83.43	Professional		$52.45	$59.13	$83.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.36 / $25.82 / $35.61	Professional	26	$22.36	$25.82	$35.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $33.31 / $47.82	Professional	TC	$30.09	$33.31	$47.82