Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.73 / $23.43 / $38.93	Facility	26	$17.73	$23.43	$38.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.54 / $120.98 / $177.95	Professional		$97.54	$120.98	$177.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.77 / $25.20 / $42.73	Professional	26	$18.77	$25.20	$42.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.83 / $69.83 / $69.83	Professional		$69.83	$69.83	$69.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $89.63 / $144.02	Professional		$27.04	$89.63	$144.02
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $28.58 / $31.15	Professional	26	$28.58	$28.58	$31.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $137.54 / $257.92	Professional		$89.67	$137.54	$257.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $32.04 / $57.99	Professional	26	$23.55	$32.04	$57.99
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.71 / $164.71 / $199.14	Professional	50	$164.71	$164.71	$199.14
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $80.98 / $148.53 / $148.53	Facility	26	$80.98	$148.53	$148.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $963.76 / $963.76 / $963.76	Professional		$963.76	$963.76	$963.76
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $236.11 / $236.11 / $250.13	Professional	26	$236.11	$236.11	$250.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $130.60 / $172.39 / $417.92	Professional		$130.60	$172.39	$417.92
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.27 / $48.58 / $117.76	Professional	26	$38.27	$48.58	$117.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.69 / $90.64 / $183.27	Professional		$32.69	$90.64	$183.27
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.03 / $149.53 / $344.84	Professional		$90.03	$149.53	$344.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.65 / $31.03 / $54.94	Professional	26	$23.65	$31.03	$54.94
United Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $131.65 / $216.02	Professional		$104.98	$131.65	$216.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $28.11 / $47.35	Professional	26	$23.67	$28.11	$47.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $99.76 / $141.74	Professional		$89.17	$99.76	$141.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.13 / $28.84 / $39.78	Professional	26	$25.13	$28.84	$39.78