Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $19.05 / $21.88	Facility	26	$16.98	$19.05	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $190.55	Professional		$89.13	$120.23	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $102.33	Professional		$75.86	$75.86	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $91.20 / $141.25	Professional		$26.92	$91.20	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $43.65	Facility	26	$6.61	$30.90	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $257.04	Professional		$91.20	$131.83	$257.04
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,096.48 / $1,096.48	Professional		$891.25	$1,096.48	$1,096.48
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $18.62 / $21.88	Facility	26	$16.98	$18.62	$21.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $288.40	Professional		$93.33	$131.83	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.11 / $109.65	Professional		$22.39	$33.11	$109.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $123.03 / $257.04	Professional		$28.18	$123.03	$257.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $43.65	Facility	26	$6.61	$30.90	$43.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $288.40	Professional		$89.13	$131.83	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $186.21	Professional		$93.33	$117.49	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $131.83 / $158.49	Professional		$125.89	$131.83	$158.49