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 $35.31 / $43.33 / $60.38	Professional		$35.31	$43.33	$60.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.83 / $11.85 / $17.32	Professional	26	$9.83	$11.85	$17.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $31.21 / $44.08	Professional	TC	$25.37	$31.21	$44.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $41.72 / $58.41	Professional		$36.65	$41.72	$58.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $11.16 / $14.72	Professional	26	$10.15	$11.16	$14.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.68 / $29.68 / $29.68	Professional	TC	$29.68	$29.68	$29.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.58 / $31.87 / $59.11	Professional		$10.58	$31.87	$59.11
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $43.63 / $54.24 / $98.82	Professional		$43.63	$54.24	$98.82
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $18.89 / $18.89	Professional	26	$11.88	$18.89	$18.89
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 $42.80 / $54.86 / $84.38	Professional		$42.80	$54.86	$84.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $15.36 / $24.00	Professional	26	$11.72	$15.36	$24.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $39.58 / $60.10	Professional	TC	$30.76	$39.58	$60.10
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 $277.95 / $277.95 / $377.85	Professional		$277.95	$277.95	$377.85
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 $203.39 / $203.39 / $284.02	Professional	TC	$203.39	$203.39	$284.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.72 / $56.77 / $90.46	Professional		$41.72	$56.77	$90.46
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 $37.95 / $46.20 / $61.14	Professional	TC	$37.95	$46.20	$61.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.99 / $39.04 / $64.45	Professional		$11.99	$39.04	$64.45
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 $44.05 / $59.29 / $106.57	Professional		$44.05	$59.29	$106.57
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $15.45 / $23.32	Professional	26	$11.86	$15.45	$23.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $39.79 / $58.97	Professional	TC	$30.76	$39.79	$58.97
United Facility/Professional Professional Modifier Low / Median / High Price $34.09 / $46.21 / $70.59	Professional		$34.09	$46.21	$70.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.90 / $13.24 / $20.16	Professional	26	$9.90	$13.24	$20.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $32.63 / $51.04	Professional	TC	$24.30	$32.63	$51.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $41.72 / $59.29	Professional		$37.27	$41.72	$59.29
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 $27.61 / $30.56 / $43.92	Professional	TC	$27.61	$30.56	$43.92