Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.80 / $20.10 / $31.72	Facility	26	$16.80	$20.10	$31.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.34 / $33.94 / $55.39	Professional		$27.34	$33.94	$55.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $22.41 / $38.33	Professional	26	$18.27	$22.41	$38.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.67 / $16.68 / $21.82	Professional	52	$13.67	$16.68	$21.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.07 / $11.54 / $15.67	Professional	TC	$9.07	$11.54	$15.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $34.27 / $46.98	Professional		$29.42	$34.27	$46.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.85 / $22.80 / $26.94	Professional	26	$18.85	$22.80	$26.94
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.08 / $8.08 / $8.19	Professional	52	$8.08	$8.08	$8.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.51 / $27.75 / $45.47	Professional		$17.51	$27.75	$45.47
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $43.65 / $75.34	Professional		$33.95	$43.65	$75.34
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.18 / $21.18 / $22.44	Professional	26	$21.18	$21.18	$22.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $42.33 / $65.91	Professional		$32.97	$42.33	$65.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.74 / $28.28 / $44.58	Professional	26	$21.74	$28.28	$44.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.99 / $14.20 / $21.65	Professional	TC	$10.99	$14.20	$21.65
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $51.77 / $98.42 / $106.50	Facility	26	$51.77	$98.42	$106.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $209.51 / $209.51 / $283.13	Professional		$209.51	$209.51	$283.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.46 / $138.46 / $174.45	Professional	26	$138.46	$138.46	$174.45
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.05 / $71.05 / $108.68	Professional	TC	$71.05	$71.05	$108.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $46.65 / $88.20	Professional		$33.32	$46.65	$88.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.18 / $30.03 / $43.32	Professional	26	$24.18	$30.03	$43.32
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $32.69 / $32.69 / $32.69	Professional	52	$32.69	$32.69	$32.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $17.21 / $22.86	Professional	TC	$14.13	$17.21	$22.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.08 / $24.55 / $45.26	Professional		$13.08	$24.55	$45.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $45.86 / $81.73	Professional		$33.97	$45.86	$81.73
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $28.28 / $43.09	Professional	26	$22.02	$28.28	$43.09
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.99 / $14.21 / $20.93	Professional	TC	$10.99	$14.21	$20.93
United Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $36.00 / $57.08	Professional		$27.30	$36.00	$57.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.11 / $23.97 / $37.33	Professional	26	$18.11	$23.97	$37.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.66 / $11.52 / $17.87	Professional	TC	$8.66	$11.52	$17.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.44 / $32.33 / $45.21	Professional		$28.44	$32.33	$45.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.95 / $20.72 / $28.55	Professional	26	$17.95	$20.72	$28.55
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.49 / $11.61 / $16.66	Professional	TC	$10.49	$11.61	$16.66