Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.48 / $111.14 / $158.96	Facility	26	$102.48	$111.14	$158.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.49 / $378.49 / $502.14	Professional		$335.49	$378.49	$502.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.33 / $111.14 / $148.32	Professional	26	$100.33	$111.14	$148.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.98 / $272.45 / $345.80	Professional	TC	$220.98	$272.45	$345.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.07 / $280.11 / $526.00	Professional		$95.07	$280.11	$526.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $104.14 / $104.14 / $104.14	Professional	26	$104.14	$104.14	$104.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.15 / $442.07 / $689.95	Professional		$335.15	$442.07	$689.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.45 / $143.62 / $220.79	Professional	26	$110.45	$143.62	$220.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.96 / $305.14 / $488.91	Professional	TC	$229.96	$305.14	$488.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $243.55 / $473.80 / $507.92	Facility	26	$243.55	$473.80	$507.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,451.44 / $2,710.64 / $2,864.93	Professional		$2,451.44	$2,710.64	$2,864.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $764.48 / $785.60 / $859.80	Professional	26	$764.48	$785.60	$859.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,717.44 / $1,925.04 / $2,005.13	Professional	TC	$1,717.44	$1,925.04	$2,005.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $315.76 / $505.30 / $594.47	Professional		$315.76	$505.30	$594.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.61 / $154.90 / $182.23	Professional	26	$131.61	$154.90	$182.23
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $297.70 / $350.39 / $412.22	Professional	TC	$297.70	$350.39	$412.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $411.80 / $411.80 / $411.80	Professional		$411.80	$411.80	$411.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $339.09 / $455.91 / $760.24	Professional		$339.09	$455.91	$760.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $112.46 / $144.93 / $220.79	Professional	26	$112.46	$144.93	$220.79
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $229.96 / $305.14 / $493.86	Professional	TC	$229.96	$305.14	$493.86
United Facility/Professional Professional Modifier Low / Median / High Price $267.43 / $362.76 / $589.41	Professional		$267.43	$362.76	$589.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.93 / $122.28 / $188.98	Professional	26	$88.93	$122.28	$188.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $176.40 / $245.41 / $404.50	Professional	TC	$176.40	$245.41	$404.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $281.87 / $315.76 / $447.97	Professional		$281.87	$315.76	$447.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $86.41 / $99.35 / $136.76	Professional	26	$86.41	$99.35	$136.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $195.45 / $216.41 / $311.22	Professional	TC	$195.45	$216.41	$311.22