Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.89 / $13.00 / $16.07	Facility	26	$10.89	$13.00	$16.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $39.21 / $59.75	Professional		$31.41	$39.21	$59.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $14.22 / $20.99	Professional	26	$11.72	$14.22	$20.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.37 / $24.83 / $34.25	Professional	TC	$19.37	$24.83	$34.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $36.31 / $46.87	Professional		$30.86	$36.31	$46.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $14.33 / $16.45	Professional	26	$13.39	$14.33	$16.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.11 / $27.04 / $51.84	Professional		$12.11	$27.04	$51.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.20 / $67.17	Professional		$36.31	$47.20	$67.17
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $47.46 / $47.46	Professional	26	$14.20	$47.46	$47.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.10 / $48.25 / $73.11	Professional		$37.10	$48.25	$73.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.05 / $18.36 / $28.80	Professional	26	$14.05	$18.36	$28.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $29.99 / $45.38	Professional	TC	$22.86	$29.99	$45.38
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $100.00 / $100.00	Facility	26	$33.53	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $348.00 / $348.00 / $348.00	Professional		$348.00	$348.00	$348.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.60 / $89.60 / $112.43	Professional	26	$89.60	$89.60	$112.43
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.00 / $198.00 / $213.38	Professional	TC	$198.00	$198.00	$213.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $37.85 / $49.21 / $67.56	Professional		$37.85	$49.21	$67.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.63 / $19.41 / $26.50	Professional	26	$15.63	$19.41	$26.50
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.90 / $35.18 / $47.31	Professional	TC	$27.90	$35.18	$47.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.33 / $29.21 / $52.32	Professional		$14.33	$29.21	$52.32
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $52.44 / $94.63	Professional		$38.04	$52.44	$94.63
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.25 / $18.36 / $28.05	Professional	26	$14.25	$18.36	$28.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $30.08 / $44.70	Professional	TC	$23.14	$30.08	$44.70
United Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $40.32 / $61.85	Professional		$30.51	$40.32	$61.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $15.37 / $23.86	Professional	26	$11.71	$15.37	$23.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $25.47 / $38.34	Professional	TC	$19.20	$25.47	$38.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $36.31 / $51.39	Professional		$32.29	$36.31	$51.39
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $13.39 / $18.47	Professional	26	$11.60	$13.39	$18.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $22.92 / $32.93	Professional	TC	$20.71	$22.92	$32.93