Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.08 / $90.49 / $122.47	Facility	26	$69.08	$90.49	$122.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $389.70 / $620.50	Professional		$250.00	$389.70	$620.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $109.67 / $167.00	Professional	26	$69.08	$109.67	$167.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $211.64 / $211.64 / $211.64	Professional		$211.64	$211.64	$211.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $131.77 / $137.15	Professional	26	$63.89	$131.77	$137.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.59 / $218.06 / $332.80	Professional		$69.59	$218.06	$332.80
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $79.06 / $85.60	Professional	26	$79.06	$79.06	$85.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.30 / $415.41 / $871.03	Professional		$230.30	$415.41	$871.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.96 / $99.54 / $183.52	Professional	26	$63.96	$99.54	$183.52
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $612.55 / $771.20 / $789.76	Facility	26	$612.55	$771.20	$789.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,480.43 / $3,584.85 / $3,584.85	Professional		$3,480.43	$3,584.85	$3,584.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $701.72 / $701.72 / $701.72	Professional	26	$701.72	$701.72	$701.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $335.19 / $442.45 / $654.05	Professional		$335.19	$442.45	$654.05
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.55 / $133.96 / $324.76	Professional	26	$105.55	$133.96	$324.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $90.12 / $225.46 / $452.80	Professional		$90.12	$225.46	$452.80
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.67 / $470.75 / $856.85	Professional		$239.67	$470.75	$856.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.87 / $94.47 / $177.60	Professional	26	$69.87	$94.47	$177.60
United Facility/Professional Professional Modifier Low / Median / High Price $268.64 / $388.51 / $792.99	Professional		$268.64	$388.51	$792.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.05 / $91.31 / $173.58	Professional	26	$73.05	$91.31	$173.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $228.86 / $256.52 / $364.23	Professional		$228.86	$256.52	$364.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.29 / $79.86 / $110.23	Professional	26	$69.29	$79.86	$110.23