Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.78 / $23.85 / $36.89	Facility	26	$16.78	$23.85	$36.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $50.01 / $197.60	Professional		$36.01	$50.01	$197.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $27.39 / $44.08	Professional	26	$18.93	$27.39	$44.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.52 / $22.21 / $34.39	Professional	TC	$15.52	$22.21	$34.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $34.22 / $53.83	Professional		$28.99	$34.22	$53.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $32.40 / $46.50	Professional	26	$22.87	$32.40	$46.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $38.68 / $45.50	Professional		$24.77	$38.68	$45.50
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $63.32 / $82.82	Professional		$41.41	$63.32	$82.82
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $27.40 / $29.32 / $29.32	Professional	26	$27.40	$29.32	$29.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $141.63 / $141.63	Facility	26	$85.00	$141.63	$141.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $334.42 / $334.42 / $362.25	Professional		$334.42	$334.42	$362.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $182.49 / $182.49 / $229.28	Professional	26	$182.49	$182.49	$229.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.88 / $151.88 / $151.88	Professional	TC	$151.88	$151.88	$151.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $71.50 / $144.94	Professional		$41.41	$71.50	$144.94
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $48.11 / $65.47	Professional	26	$35.74	$48.11	$65.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.08 / $60.80	Professional	TC	$19.76	$25.08	$60.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.29 / $35.22 / $71.54	Professional		$15.29	$35.22	$71.54
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $132.40	Professional		$39.28	$39.28	$132.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.53 / $91.19	Professional		$45.71	$61.53	$91.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.54 / $33.75 / $51.25	Professional	26	$24.54	$33.75	$51.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $27.78 / $40.92	Professional	TC	$20.21	$27.78	$40.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $41.41 / $57.98	Professional		$36.44	$41.41	$57.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $27.04 / $37.31	Professional	26	$23.46	$27.04	$37.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.97 / $14.37 / $20.67	Professional	TC	$12.97	$14.37	$20.67