Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $19.05 / $33.11	Facility	26	$14.13	$19.05	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $190.55	Professional		$89.13	$120.23	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $41.69	Professional	26	$15.85	$21.88	$41.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $109.65	Professional		$72.44	$85.11	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.88 / $28.18	Professional	26	$19.05	$21.88	$28.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $95.50 / $138.04	Professional		$19.95	$95.50	$138.04
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $22.39 / $23.44	Professional	26	$21.38	$22.39	$23.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $257.04	Professional		$91.20	$131.83	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $54.95	Professional	26	$19.05	$26.92	$54.95
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	26	$144.54	$144.54	$144.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,122.02	Professional		$891.25	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	26	$186.21	$186.21	$186.21
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $18.62 / $33.11	Facility	26	$14.13	$18.62	$33.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $263.03	Professional		$91.20	$128.82	$263.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.91 / $45.71	Professional	26	$15.85	$22.91	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $33.11 / $112.20	Professional		$19.50	$33.11	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $134.90 / $263.03	Professional		$23.99	$134.90	$263.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $281.84	Professional		$89.13	$131.83	$281.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.12 / $45.71	Professional	26	$19.05	$25.12	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $190.55	Professional		$97.72	$117.49	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $39.81	Professional	26	$19.95	$23.99	$39.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $131.83 / $158.49	Professional		$125.89	$131.83	$158.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $23.44 / $27.54	Professional	26	$22.39	$23.44	$27.54