Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $20.89 / $100.00	Facility	26	$18.20	$20.89	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $89.13	Professional		$30.20	$37.15	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $70.79	Professional	26	$19.95	$23.99	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $11.75 / $20.42	Professional	TC	$8.91	$11.75	$20.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $35.48 / $48.98	Professional		$28.18	$35.48	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $24.55 / $28.84	Professional	26	$19.05	$24.55	$28.84
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.91 / $8.91 / $8.91	Professional	52	$8.91	$8.91	$8.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.18 / $42.66	Professional		$17.78	$28.18	$42.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $48.98 / $93.33	Professional		$33.88	$48.98	$93.33
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.38 / $22.39	Professional	26	$21.38	$21.38	$22.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.37 / $25.12 / $35.48	Facility	26	$5.37	$25.12	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $69.18	Professional		$33.11	$42.66	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.84 / $46.77	Professional	26	$21.88	$28.84	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $14.13 / $22.91	Professional	TC	$10.96	$14.13	$22.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $281.84	Professional		$208.93	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $173.78 / $173.78	Professional	26	$138.04	$173.78	$173.78
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $109.65 / $109.65	Professional	TC	$70.79	$109.65	$109.65
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $19.95 / $31.62	Facility	26	$16.98	$19.95	$31.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.02 / $72.44	Professional		$30.20	$38.02	$72.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.12 / $47.86	Professional	26	$19.95	$25.12	$47.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $12.02 / $25.70	Professional	TC	$8.91	$12.02	$25.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $28.84 / $33.11	Professional		$9.77	$28.84	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $38.90 / $81.28	Professional		$15.14	$38.90	$81.28
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $35.48 / $35.48	Facility	26	$35.48	$35.48	$35.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.65 / $77.62	Professional		$33.11	$43.65	$77.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $42.66	Professional	26	$21.38	$28.18	$42.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $14.13 / $21.38	Professional	TC	$10.72	$14.13	$21.38
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $36.31 / $57.54	Professional		$27.54	$36.31	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $24.55 / $38.90	Professional	26	$18.62	$24.55	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $12.02 / $19.05	Professional	TC	$9.12	$12.02	$19.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $35.48 / $44.67	Professional		$26.30	$35.48	$44.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.39 / $27.54	Professional	26	$16.60	$22.39	$27.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $13.49 / $16.98	Professional	TC	$9.77	$13.49	$16.98