Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.86 / $40.51 / $49.60	Facility	26	$33.86	$40.51	$49.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $86.17 / $119.53	Professional		$70.98	$86.17	$119.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.67 / $44.16 / $58.71	Professional	26	$36.67	$44.16	$58.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $41.64 / $57.90	Professional	TC	$34.82	$41.64	$57.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $80.76 / $85.60	Professional		$63.84	$80.76	$85.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.33 / $41.33 / $41.33	Professional	26	$41.33	$41.33	$41.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $69.87 / $118.68	Professional		$38.34	$69.87	$118.68
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $101.17 / $140.00	Professional		$83.86	$101.17	$140.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.92 / $43.51 / $43.51	Professional	26	$40.92	$43.51	$43.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.09 / $110.34 / $166.72	Professional		$75.09	$110.34	$166.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.39 / $57.45 / $88.00	Professional	26	$43.39	$57.45	$88.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.70 / $50.20 / $83.07	Professional	TC	$31.70	$50.20	$83.07
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $102.35 / $215.13 / $215.13	Facility	26	$102.35	$215.13	$215.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $567.30 / $567.30 / $715.35	Professional		$567.30	$567.30	$715.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $318.67 / $318.67 / $349.28	Professional	26	$318.67	$318.67	$349.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $318.67 / $318.67 / $366.08	Professional	TC	$318.67	$318.67	$366.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $146.62 / $183.32	Professional		$98.27	$146.62	$183.32
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $64.34 / $78.20	Professional	26	$49.32	$64.34	$78.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.95 / $63.85 / $77.62	Professional	TC	$48.95	$63.85	$77.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $72.81 / $149.66	Professional		$42.89	$72.81	$149.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.80 / $215.40	Professional		$83.18	$117.80	$215.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $43.81 / $58.79 / $88.00	Professional	26	$43.81	$58.79	$88.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.59 / $50.90 / $82.55	Professional	TC	$33.59	$50.90	$82.55
United Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $91.73 / $141.16	Professional		$65.78	$91.73	$141.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.01 / $48.89 / $78.34	Professional	26	$37.01	$48.89	$78.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.61 / $42.06 / $65.97	Professional	TC	$29.61	$42.06	$65.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.50 / $83.86 / $113.82	Professional		$71.50	$83.86	$113.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $42.25 / $57.16	Professional	26	$35.89	$42.25	$57.16
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.61 / $41.61 / $56.67	Professional	TC	$35.61	$41.61	$56.67