Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.82 / $23.26 / $35.22	Facility	26	$17.82	$23.26	$35.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.93 / $80.34 / $131.33	Professional		$59.93	$80.34	$131.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $55.55 / $90.23	Professional	TC	$40.84	$55.55	$90.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $63.96 / $107.73	Professional		$29.46	$63.96	$107.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Facility	26	$31.62	$31.62	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.41 / $105.02 / $198.51	Professional		$70.41	$105.02	$198.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.43 / $73.67 / $137.27	Professional	TC	$47.43	$73.67	$137.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.44 / $134.57 / $134.57	Facility	26	$83.44	$134.57	$134.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $673.71 / $673.71 / $738.53	Professional		$673.71	$673.71	$738.53
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $514.25 / $514.25 / $517.20	Professional	TC	$514.25	$514.25	$517.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.74 / $140.88 / $341.56	Professional		$106.74	$140.88	$341.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.53 / $97.14 / $235.48	Professional	TC	$76.53	$97.14	$235.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.99 / $89.64 / $171.72	Professional		$31.99	$89.64	$171.72
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Facility	26	$31.62	$31.62	$31.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $73.54 / $115.33 / $236.13	Professional		$73.54	$115.33	$236.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $49.82 / $71.73 / $137.27	Professional	TC	$49.82	$71.73	$137.27
United Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $101.75 / $168.73	Professional		$79.40	$101.75	$168.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.53 / $73.08 / $115.64	Professional	TC	$54.53	$73.08	$115.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.88 / $81.70 / $115.91	Professional		$72.88	$81.70	$115.91
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $50.24 / $55.63 / $79.92	Professional	TC	$50.24	$55.63	$79.92