Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.08 / $90.52 / $123.32	Facility	26	$69.08	$90.52	$123.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.45 / $463.36 / $745.68	Professional		$298.45	$463.36	$745.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $112.50 / $197.62	Professional	26	$69.08	$112.50	$197.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.12 / $335.00 / $493.31	Professional	TC	$226.12	$335.00	$493.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $318.00	Professional		$318.00	$318.00	$318.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $64.40 / $148.27	Professional	26	$64.40	$64.40	$148.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $269.00 / $413.85	Professional		$76.00	$269.00	$413.85
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.69 / $79.69 / $85.30	Professional	26	$79.69	$79.69	$85.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.81 / $489.92 / $923.45	Professional		$285.81	$489.92	$923.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $97.75 / $175.72	Professional	26	$64.39	$97.75	$175.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $214.72 / $387.60 / $719.14	Professional	TC	$214.72	$387.60	$719.14
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $618.08 / $776.00 / $789.92	Facility	26	$618.08	$776.00	$789.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,014.38 / $3,039.70 / $3,039.70	Professional		$3,014.38	$3,039.70	$3,039.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $597.70 / $597.70 / $683.48	Professional	26	$597.70	$597.70	$683.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,544.17 / $2,573.94 / $2,613.88	Professional	TC	$2,544.17	$2,573.94	$2,613.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $390.81 / $549.73 / $806.34	Professional		$390.81	$549.73	$806.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.39 / $135.04 / $327.36	Professional	26	$106.39	$135.04	$327.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $326.73 / $414.69 / $1,005.32	Professional	TC	$326.73	$414.69	$1,005.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.44 / $311.14 / $623.09	Professional		$92.44	$311.14	$623.09
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $296.89 / $532.15 / $990.65	Professional		$296.89	$532.15	$990.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.89 / $91.77 / $172.59	Professional	26	$69.89	$91.77	$172.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $214.72 / $372.56 / $719.14	Professional	TC	$214.72	$372.56	$719.14
United Facility/Professional Professional Modifier Low / Median / High Price $333.14 / $460.02 / $806.13	Professional		$333.14	$460.02	$806.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.76 / $90.95 / $157.44	Professional	26	$72.76	$90.95	$157.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $240.78 / $351.38 / $601.96	Professional	TC	$240.78	$351.38	$601.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.35 / $318.00 / $452.45	Professional		$284.35	$318.00	$452.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $80.50 / $111.00	Professional	26	$69.84	$80.50	$111.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $214.50 / $250.71 / $1,400.00	Professional	TC	$214.50	$250.71	$1,400.00