Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $9.83 / $15.04	Facility	26	$7.59	$9.83	$15.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.90 / $40.39 / $75.30	Professional		$29.90	$40.39	$75.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.18 / $18.54	Professional	26	$8.02	$10.18	$18.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $28.90 / $48.57	Professional	TC	$21.76	$28.90	$48.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $43.83 / $74.05	Professional		$28.98	$43.83	$74.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.14 / $21.72	Professional	26	$8.91	$11.14	$21.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.94 / $16.94 / $16.94	Professional	TC	$16.94	$16.94	$16.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.74 / $31.04 / $48.68	Professional		$9.74	$31.04	$48.68
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $11.58 / $26.55	Professional	26	$11.03	$11.58	$26.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $48.83 / $85.54	Professional		$33.22	$48.83	$85.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $12.45 / $23.22	Professional	26	$8.83	$12.45	$23.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.06 / $35.94 / $64.31	Professional	TC	$24.06	$35.94	$64.31
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $103.00 / $103.00	Facility	26	$29.45	$103.00	$103.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $286.68 / $286.68 / $375.30	Professional		$286.68	$286.68	$375.30
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.32 / $107.32 / $107.32	Professional	26	$107.32	$107.32	$107.32
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.00 / $267.00 / $281.25	Professional	TC	$267.00	$267.00	$281.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $65.01 / $101.27	Professional		$41.40	$65.01	$101.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.72 / $18.68 / $45.28	Professional	26	$14.72	$18.68	$45.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.56 / $48.03 / $128.08	Professional	TC	$37.56	$48.03	$128.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.57 / $38.72 / $72.63	Professional		$12.57	$38.72	$72.63
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $53.39 / $115.71	Professional		$34.58	$53.39	$115.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.28 / $22.28	Professional	26	$8.91	$12.28	$22.28
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $35.15 / $63.16	Professional	TC	$24.44	$35.15	$63.16
United Facility/Professional Professional Modifier Low / Median / High Price $35.44 / $43.67 / $72.06	Professional		$35.44	$43.67	$72.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $12.00 / $19.84	Professional	26	$9.46	$12.00	$19.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $32.08 / $50.65	Professional	TC	$24.83	$32.08	$50.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $41.40 / $58.86	Professional		$36.99	$41.40	$58.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.14 / $15.38	Professional	26	$9.66	$11.14	$15.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.33 / $30.26 / $43.48	Professional	TC	$27.33	$30.26	$43.48