Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.00 / $30.52 / $38.42	Facility	26	$26.00	$30.52	$38.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $98.99 / $144.60	Professional		$65.04	$98.99	$144.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $34.35 / $47.34	Professional	26	$28.14	$34.35	$47.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.10 / $67.28 / $91.82	Professional	TC	$34.10	$67.28	$91.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $94.07 / $114.29	Professional		$87.48	$94.07	$114.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.53 / $31.89 / $41.62	Professional	26	$29.53	$31.89	$41.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $74.72 / $139.38	Professional		$27.04	$74.72	$139.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $118.21 / $174.03	Professional		$98.29	$118.21	$174.03
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $31.72 / $32.29 / $33.52	Professional	26	$31.72	$32.29	$33.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $111.24 / $178.89	Professional		$69.00	$111.24	$178.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.24 / $43.96 / $67.00	Professional	26	$33.24	$43.96	$67.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.68 / $68.38 / $110.94	Professional	TC	$33.68	$68.38	$110.94
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.13 / $167.77 / $167.77	Facility	26	$78.13	$167.77	$167.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $687.40 / $687.40 / $848.78	Professional		$687.40	$687.40	$848.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $224.56 / $224.56 / $273.38	Professional	26	$224.56	$224.56	$273.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $472.45 / $472.45 / $575.40	Professional	TC	$472.45	$472.45	$575.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $94.07 / $144.46 / $375.00	Professional		$94.07	$144.46	$375.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.32 / $49.99 / $60.77	Professional	26	$38.32	$49.99	$60.77
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.02 / $100.46 / $163.10	Professional	TC	$77.02	$100.46	$163.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $85.96 / $169.44	Professional		$36.06	$85.96	$169.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.06 / $119.26 / $249.14	Professional		$77.06	$119.26	$249.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $45.45 / $66.95	Professional	26	$33.29	$45.45	$66.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $37.29 / $69.80 / $106.33	Professional	TC	$37.29	$69.80	$106.33
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $91.20 / $151.00	Professional		$62.50	$91.20	$151.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.76 / $37.52 / $59.61	Professional	26	$27.76	$37.52	$59.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.39 / $50.88 / $90.04	Professional	TC	$26.39	$50.88	$90.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.92 / $98.29 / $133.57	Professional		$83.92	$98.29	$133.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $32.78 / $44.36	Professional	26	$27.88	$32.78	$44.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.04 / $65.50 / $89.21	Professional	TC	$56.04	$65.50	$89.21