Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.24 / $2.75 / $3.04	Facility	26	$2.24	$2.75	$3.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.63 / $16.62 / $28.66	Professional		$13.63	$16.62	$28.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.54 / $3.40 / $6.00	Professional	26	$2.54	$3.40	$6.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.95 / $13.40 / $22.39	Professional	TC	$10.95	$13.40	$22.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.76 / $11.76 / $14.88	Professional		$11.76	$11.76	$14.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.52 / $2.82 / $3.32	Professional	26	$2.52	$2.82	$3.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.42 / $10.79 / $20.01	Professional		$2.42	$10.79	$20.01
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $19.53 / $32.81	Professional		$14.53	$19.53	$32.81
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $2.50 / $2.62 / $2.82	Professional	26	$2.50	$2.62	$2.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.06 / $3.06 / $3.06	Facility	26	$3.06	$3.06	$3.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.62 / $26.92 / $41.98	Professional		$15.62	$26.92	$41.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.88 / $5.80 / $9.75	Professional	26	$2.88	$5.80	$9.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.61 / $20.77 / $33.33	Professional	TC	$12.61	$20.77	$33.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.94 / $100.00 / $100.00	Facility	26	$5.94	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $161.00 / $161.00	Professional		$161.00	$161.00	$161.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.02 / $54.00 / $54.00	Professional	26	$33.02	$54.00	$54.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.00 / $129.00 / $129.00	Professional	TC	$129.00	$129.00	$129.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.56 / $20.38 / $27.08	Professional		$14.56	$20.38	$27.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.98 / $3.70 / $5.89	Professional	26	$2.98	$3.70	$5.89
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.77 / $16.76 / $22.26	Professional	TC	$13.77	$16.76	$22.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2.64 / $13.73 / $23.09	Professional		$2.64	$13.73	$23.09
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.06 / $3.06 / $3.06	Facility	26	$3.06	$3.06	$3.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $16.09 / $28.81 / $44.13	Professional		$16.09	$28.81	$44.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $2.90 / $5.81 / $9.61	Professional	26	$2.90	$5.81	$9.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.74 / $21.17 / $33.22	Professional	TC	$12.74	$21.17	$33.22
United Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $25.01 / $39.07	Professional		$18.19	$25.01	$39.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.75 / $5.34 / $8.30	Professional	26	$3.75	$5.34	$8.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.92 / $19.35 / $30.31	Professional	TC	$13.92	$19.35	$30.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.43 / $13.84 / $19.68	Professional		$12.43	$13.84	$19.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.21 / $2.52 / $3.47	Professional	26	$2.21	$2.52	$3.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.22 / $11.31 / $16.21	Professional	TC	$10.22	$11.31	$16.21