Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.38 / $49.93 / $76.03	Facility	26	$38.38	$49.93	$76.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.93 / $192.33 / $342.58	Professional		$153.93	$192.33	$342.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.79 / $50.31 / $89.79	Professional	26	$39.79	$50.31	$89.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.06 / $56.32 / $109.83	Professional	26	$45.06	$56.32	$109.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.59 / $155.13 / $261.24	Professional		$74.59	$155.13	$261.24
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $55.75 / $55.75 / $59.98	Professional	26	$55.75	$55.75	$59.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.32 / $217.26 / $413.49	Professional		$156.32	$217.26	$413.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.24 / $60.82 / $111.27	Professional	26	$42.24	$60.82	$111.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $140.44 / $290.64 / $290.64	Facility	26	$140.44	$290.64	$290.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,471.51 / $1,471.51 / $1,803.15	Professional		$1,471.51	$1,471.51	$1,803.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $378.45 / $378.45 / $476.93	Professional	26	$378.45	$378.45	$476.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $244.72 / $344.24 / $519.29	Professional		$244.72	$344.24	$519.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $94.46 / $229.00	Professional	26	$74.43	$94.46	$229.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $189.11 / $344.24	Professional		$63.54	$189.11	$344.24
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $168.56 / $251.48 / $563.97	Professional		$168.56	$251.48	$563.97
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.67 / $60.50 / $109.62	Professional	26	$41.67	$60.50	$109.62
United Facility/Professional Professional Modifier Low / Median / High Price $173.26 / $213.94 / $353.74	Professional		$173.26	$213.94	$353.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $60.86 / $100.13	Professional	26	$43.40	$60.86	$100.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $178.06 / $199.37 / $283.39	Professional		$178.06	$199.37	$283.39
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $56.32 / $77.70	Professional	26	$48.86	$56.32	$77.70