Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $7.94 / $12.59	Facility	26	$6.76	$7.94	$12.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $158.49	Professional		$51.29	$63.10	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.33 / $32.36	Professional	26	$7.94	$9.33	$32.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $50.12 / $91.20	Professional	TC	$41.69	$50.12	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $54.95 / $74.13	Professional		$45.71	$54.95	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $12.59	Professional	26	$7.94	$9.77	$12.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	TC	$46.77	$46.77	$46.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $40.74 / $77.62	Professional		$7.08	$40.74	$77.62
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $64.57 / $123.03	Professional		$37.15	$64.57	$123.03
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.12 / $9.33	Professional	26	$9.12	$9.12	$9.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $114.82	Professional		$54.95	$70.79	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.22 / $18.20	Professional	26	$8.71	$11.22	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $60.26 / $95.50	Professional	TC	$45.71	$60.26	$95.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $85.11	Facility	26	$79.43	$79.43	$85.11
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $467.74 / $467.74	Professional		$371.54	$467.74	$467.74
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $70.79	Professional	26	$54.95	$70.79	$70.79
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $407.38 / $407.38	Professional	TC	$316.23	$407.38	$407.38
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $8.32 / $12.30	Facility	26	$6.76	$8.32	$12.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $123.03	Professional		$51.29	$64.57	$123.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.00 / $21.38	Professional	26	$7.59	$10.00	$21.38
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $97.72	Professional	TC	$42.66	$52.48	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $33.11 / $44.67	Professional		$6.92	$33.11	$44.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $64.57 / $138.04	Professional		$10.23	$64.57	$138.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Facility	26	$14.13	$14.13	$14.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $125.89	Professional		$53.70	$72.44	$125.89
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.96 / $17.38	Professional	26	$8.51	$10.96	$17.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $58.88 / $89.13	Professional	TC	$44.67	$58.88	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $95.50	Professional		$45.71	$60.26	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.77 / $15.14	Professional	26	$7.41	$9.77	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $50.12 / $79.43	Professional	TC	$38.02	$50.12	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $75.86	Professional		$42.66	$60.26	$75.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $11.48	Professional	26	$6.61	$9.12	$11.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $51.29 / $64.57	Professional	TC	$36.31	$51.29	$64.57