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 / $49.96	Facility	26	$33.86	$40.51	$49.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $131.60 / $196.63	Professional		$103.50	$131.60	$196.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $44.16 / $61.30	Professional	26	$36.97	$44.16	$61.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.02 / $84.93 / $127.51	Professional	TC	$66.02	$84.93	$127.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.82 / $114.26 / $130.44	Professional		$101.82	$114.26	$130.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.46 / $41.63 / $43.22	Professional	26	$38.46	$41.63	$43.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.07 / $87.29 / $162.84	Professional		$35.07	$87.29	$162.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $114.18 / $142.34 / $202.56	Professional		$114.18	$142.34	$202.56
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $43.18 / $43.18	Professional	26	$41.22	$43.18	$43.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $171.97 / $321.68	Professional		$115.50	$171.97	$321.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.71 / $58.64 / $89.70	Professional	26	$43.71	$58.64	$89.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.88 / $108.02 / $243.92	Professional	TC	$71.88	$108.02	$243.92
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $102.69 / $216.22 / $216.22	Facility	26	$102.69	$216.22	$216.22
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $944.58 / $944.58 / $982.43	Professional		$944.58	$944.58	$982.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $353.25 / $386.24 / $386.24	Professional	26	$353.25	$386.24	$386.24
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $782.04 / $782.04 / $782.04	Professional	TC	$782.04	$782.04	$782.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.31 / $174.70 / $479.26	Professional		$131.31	$174.70	$479.26
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $64.83 / $78.81	Professional	26	$49.70	$64.83	$78.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.23 / $109.87 / $133.57	Professional	TC	$84.23	$109.87	$133.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.85 / $95.84 / $199.81	Professional		$46.85	$95.84	$199.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.10 / $185.98 / $336.94	Professional		$123.10	$185.98	$336.94
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $44.16 / $60.77 / $89.37	Professional	26	$44.16	$60.77	$89.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $73.47 / $110.56 / $243.92	Professional	TC	$73.47	$110.56	$243.92
United Facility/Professional Professional Modifier Low / Median / High Price $105.10 / $149.52 / $237.52	Professional		$105.10	$149.52	$237.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.49 / $49.65 / $79.81	Professional	26	$36.49	$49.65	$79.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.27 / $98.81 / $160.12	Professional	TC	$67.27	$98.81	$160.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.45 / $114.18 / $155.10	Professional		$97.45	$114.18	$155.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $42.54 / $57.54	Professional	26	$36.15	$42.54	$57.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.29 / $71.63 / $97.56	Professional	TC	$61.29	$71.63	$97.56