Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.69 / $8.32 / $12.41	Facility	26	$6.69	$8.32	$12.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $57.77 / $90.60	Professional		$47.49	$57.77	$90.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.86 / $20.12	Professional	26	$7.45	$8.86	$20.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.46 / $28.20 / $37.97	Professional	52	$23.46	$28.20	$37.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.50 / $47.73 / $66.84	Professional	TC	$38.50	$47.73	$66.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $53.75 / $77.52	Professional		$49.37	$53.75	$77.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $9.14 / $10.88	Professional	26	$7.54	$9.14	$10.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $39.45 / $42.21	Professional	TC	$39.45	$39.45	$42.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.50 / $40.09 / $76.84	Professional		$7.50	$40.09	$76.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $65.59 / $122.99	Professional		$43.93	$65.59	$122.99
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $9.16 / $9.23	Professional	26	$9.16	$9.16	$9.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $70.89 / $107.63	Professional		$54.52	$70.89	$107.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $11.10 / $17.45	Professional	26	$8.63	$11.10	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.72 / $59.60 / $90.59	Professional	TC	$45.72	$59.60	$90.59
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $80.00 / $85.00	Facility	26	$20.60	$80.00	$85.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $373.69 / $373.69 / $472.95	Professional		$373.69	$373.69	$472.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $55.28 / $70.05	Professional	26	$55.28	$55.28	$70.05
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $318.41 / $318.41 / $402.90	Professional	TC	$318.41	$318.41	$402.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $76.08 / $133.65	Professional		$12.00	$76.08	$133.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $11.77 / $15.64	Professional	26	$9.67	$11.77	$15.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.82 / $64.30 / $85.43	Professional	TC	$52.82	$64.30	$85.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $53.68 / $86.80	Professional		$9.27	$53.68	$86.80
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.05 / $76.69 / $139.51	Professional		$56.05	$76.69	$139.51
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $11.13 / $17.05	Professional	26	$8.75	$11.13	$17.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $45.97 / $60.06 / $87.89	Professional	TC	$45.97	$60.06	$87.89
United Facility/Professional Professional Modifier Low / Median / High Price $44.11 / $58.78 / $91.81	Professional		$44.11	$58.78	$91.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.04 / $9.38 / $14.64	Professional	26	$7.04	$9.38	$14.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.65 / $49.79 / $77.14	Professional	TC	$36.65	$49.79	$77.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.38 / $51.68 / $73.79	Professional		$46.38	$51.68	$73.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $8.27 / $11.41	Professional	26	$7.18	$8.27	$11.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.20 / $43.40 / $62.38	Professional	TC	$39.20	$43.40	$62.38