Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.29 / $32.84 / $51.08	Facility	26	$25.29	$32.84	$51.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.64 / $96.34 / $164.68	Professional		$71.64	$96.34	$164.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.35 / $59.32 / $109.96	Professional	TC	$46.35	$59.32	$109.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $83.18 / $134.91	Professional		$43.19	$83.18	$134.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $45.47	Facility	26	$45.47	$45.47	$45.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.63 / $124.65 / $258.60	Professional		$78.63	$124.65	$258.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.88 / $83.56 / $183.91	Professional	TC	$48.88	$83.56	$183.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $103.08 / $195.84 / $195.84	Facility	26	$103.08	$195.84	$195.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,114.04 / $1,147.46 / $1,147.46	Professional		$1,114.04	$1,147.46	$1,147.46
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $909.46 / $936.75 / $936.75	Professional	TC	$909.46	$936.75	$936.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.50 / $157.19 / $249.74	Professional		$100.50	$157.19	$249.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $109.41 / $265.24	Professional	TC	$86.20	$109.41	$265.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.49 / $79.97 / $175.88	Professional		$42.49	$79.97	$175.88
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $45.47	Facility	26	$45.47	$45.47	$45.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.50 / $134.53 / $287.67	Professional		$80.50	$134.53	$287.67
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $48.39 / $82.09 / $177.58	Professional	TC	$48.39	$82.09	$177.58
United Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $121.31 / $205.03	Professional		$83.73	$121.31	$205.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.61 / $73.66 / $128.72	Professional	TC	$47.61	$73.66	$128.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.44 / $100.50 / $142.33	Professional		$89.44	$100.50	$142.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.59 / $62.66 / $90.09	Professional	TC	$56.59	$62.66	$90.09