Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.73 / $19.10 / $29.65	Facility	26	$14.73	$19.10	$29.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.66 / $120.06 / $179.76	Professional		$93.66	$120.06	$179.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.12 / $99.55 / $145.61	Professional	TC	$78.12	$99.55	$145.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $82.00 / $155.55	Professional		$30.08	$82.00	$155.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.67 / $129.13 / $251.27	Professional		$93.67	$129.13	$251.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.53 / $105.89 / $203.79	Professional	TC	$74.53	$105.89	$203.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $73.63 / $113.57 / $113.57	Facility	26	$73.63	$113.57	$113.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $923.37 / $923.37 / $1,172.33	Professional		$923.37	$923.37	$1,172.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $778.42 / $778.42 / $986.78	Professional	TC	$778.42	$778.42	$986.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $168.60 / $222.55 / $539.52	Professional		$168.60	$222.55	$539.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $146.34 / $185.74 / $450.28	Professional	TC	$146.34	$185.74	$450.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $150.78 / $262.20	Professional		$27.68	$150.78	$262.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.95 / $149.36 / $327.95	Professional		$95.95	$149.36	$327.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $74.12 / $106.37 / $197.39	Professional	TC	$74.12	$106.37	$197.39
United Facility/Professional Professional Modifier Low / Median / High Price $98.66 / $125.49 / $207.49	Professional		$98.66	$125.49	$207.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.12 / $102.17 / $161.33	Professional	TC	$78.12	$102.17	$161.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $115.12 / $128.32 / $183.22	Professional		$115.12	$128.32	$183.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $96.08 / $106.37 / $152.91	Professional	TC	$96.08	$106.37	$152.91