Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $109.65 / $144.54	Facility	26	$75.86	$109.65	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $426.58 / $794.33	Professional		$257.04	$426.58	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $245.47	Professional	26	$70.79	$120.23	$245.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $70.79 / $100.00	Professional	26	$64.57	$70.79	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $213.80 / $288.40	Professional		$67.61	$213.80	$288.40
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $81.28 / $85.11	Professional	26	$79.43	$81.28	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $95.50 / $138.04	Facility	26	$20.42	$95.50	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $436.52 / $891.25	Professional		$251.19	$436.52	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $109.65 / $213.80	Professional	26	$70.79	$109.65	$213.80
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Professional		$3,548.13	$3,548.13	$3,548.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Professional	26	$707.95	$707.95	$707.95
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $109.65 / $144.54	Facility	26	$69.18	$109.65	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $891.25	Professional		$281.84	$478.63	$891.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $269.15	Professional	26	$83.18	$128.82	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $257.04 / $776.25	Professional		$85.11	$257.04	$776.25
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $95.50 / $138.04	Facility	26	$20.42	$95.50	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $446.68 / $831.76	Professional		$257.04	$446.68	$831.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $107.15 / $177.83	Professional	26	$70.79	$107.15	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $407.38 / $741.31	Professional		$269.15	$407.38	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $91.20 / $169.82	Professional	26	$75.86	$91.20	$169.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $323.59	Professional		$257.04	$257.04	$323.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $100.00	Professional	26	$79.43	$83.18	$100.00