Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.05 / $11.25 / $16.47	Facility	26	$9.05	$11.25	$16.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $54.83 / $81.02	Professional		$45.00	$54.83	$81.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.34 / $28.98	Professional	26	$10.47	$12.34	$28.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.09 / $27.07 / $35.70	Professional	52	$22.09	$27.07	$35.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.35 / $41.81 / $59.32	Professional	TC	$34.35	$41.81	$59.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.93 / $52.42 / $78.63	Professional		$49.93	$52.42	$78.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $12.28 / $15.06	Professional	26	$10.15	$12.28	$15.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $37.65	Professional	TC	$37.65	$37.65	$37.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.09 / $38.43 / $73.66	Professional		$10.09	$38.43	$73.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $70.98 / $124.38	Professional		$53.47	$70.98	$124.38
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $12.37 / $12.37	Professional	26	$11.88	$12.37	$12.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.41 / $68.77 / $106.42	Professional		$53.41	$68.77	$106.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $15.36 / $24.01	Professional	26	$11.72	$15.36	$24.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.53 / $53.21 / $81.99	Professional	TC	$41.53	$53.21	$81.99
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $80.00 / $85.00	Facility	26	$27.92	$80.00	$85.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $346.85 / $346.85 / $478.05	Professional		$346.85	$346.85	$478.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.58 / $74.58 / $93.83	Professional	26	$74.58	$74.58	$93.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.27 / $272.27 / $384.23	Professional	TC	$272.27	$272.27	$384.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.87 / $76.47 / $128.69	Professional		$19.87	$76.47	$128.69
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.02 / $15.85 / $21.06	Professional	26	$13.02	$15.85	$21.06
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.22 / $62.36 / $81.23	Professional	TC	$50.22	$62.36	$81.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.99 / $51.58 / $83.58	Professional		$11.99	$51.58	$83.58
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $74.51 / $132.38	Professional		$54.68	$74.51	$132.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $15.45 / $23.69	Professional	26	$11.86	$15.45	$23.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.56 / $53.32 / $79.56	Professional	TC	$41.56	$53.32	$79.56
United Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $57.23 / $90.92	Professional		$43.02	$57.23	$90.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $13.24 / $20.83	Professional	26	$9.80	$13.24	$20.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.22 / $43.96 / $67.62	Professional	TC	$33.22	$43.96	$67.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $52.42 / $74.63	Professional		$46.93	$52.42	$74.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.16 / $15.38	Professional	26	$9.66	$11.16	$15.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.27 / $41.26 / $59.25	Professional	TC	$37.27	$41.26	$59.25