Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.61 / $7.29 / $11.29	Facility	26	$5.61	$7.29	$11.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $28.55 / $58.91	Professional		$21.52	$28.55	$58.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.78 / $16.05	Professional	26	$6.03	$7.78	$16.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.24 / $59.24 / $59.24	Professional	50	$59.24	$59.24	$59.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.53 / $19.94 / $30.75	Professional	TC	$15.53	$19.94	$30.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.72 / $32.13 / $62.67	Professional		$22.72	$32.13	$62.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.00 / $8.85 / $21.36	Professional	26	$6.00	$8.85	$21.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $22.87 / $35.86	Professional		$7.24	$22.87	$35.86
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $8.18 / $8.82	Professional	26	$8.18	$8.18	$8.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.34 / $31.83 / $59.93	Professional		$23.34	$31.83	$59.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $9.50 / $17.34	Professional	26	$6.71	$9.50	$17.34
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $46.30	Professional	50	$38.29	$38.29	$46.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.32 / $22.31 / $42.87	Professional	TC	$16.32	$22.31	$42.87
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $100.00 / $100.00	Facility	26	$27.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.77 / $208.77 / $278.02	Professional		$208.77	$208.77	$278.02
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $82.56 / $82.56	Professional	26	$82.56	$82.56	$82.56
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.47 / $153.47 / $207.68	Professional	TC	$153.47	$153.47	$207.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $52.83 / $128.08	Professional		$40.03	$52.83	$128.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $13.88 / $33.64	Professional	26	$10.93	$13.88	$33.64
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $23.07 / $23.07 / $23.07	Professional	50	$23.07	$23.07	$23.07
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $35.42 / $94.44	Professional	TC	$27.69	$35.42	$94.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.50 / $55.70 / $88.10	Professional		$14.50	$55.70	$88.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.72 / $36.00 / $79.56	Professional		$23.72	$36.00	$79.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $9.31 / $16.39	Professional	26	$6.74	$9.31	$16.39
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.34 / $22.31 / $42.08	Professional	TC	$16.34	$22.31	$42.08
United Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $29.83 / $49.32	Professional		$24.89	$29.83	$49.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $8.34 / $14.72	Professional	26	$6.93	$8.34	$14.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $21.60 / $34.11	Professional	TC	$17.41	$21.60	$34.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.33 / $30.57 / $43.46	Professional		$27.33	$30.57	$43.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $8.26 / $11.41	Professional	26	$7.18	$8.26	$11.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $22.31 / $32.04	Professional	TC	$20.14	$22.31	$32.04