Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $96.57 / $141.72	Professional		$73.56	$96.57	$141.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.24 / $16.60 / $26.02	Professional	26	$13.24	$16.60	$26.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.11 / $79.95 / $119.69	Professional	TC	$60.11	$79.95	$119.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $73.30 / $113.31	Professional		$15.65	$73.30	$113.31
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $17.61 / $17.61 / $18.98	Professional	26	$17.61	$17.61	$18.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $101.32 / $203.81	Professional		$66.23	$101.32	$203.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $21.35 / $38.49	Professional	26	$15.12	$21.35	$38.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.42 / $83.46 / $159.66	Professional	TC	$50.42	$83.46	$159.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $751.09 / $751.09 / $924.90	Professional		$751.09	$751.09	$924.90
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $205.00 / $205.00 / $205.00	Professional	26	$205.00	$205.00	$205.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $630.88 / $630.88 / $773.40	Professional	TC	$630.88	$630.88	$773.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $133.03 / $175.59 / $425.68	Professional		$133.03	$175.59	$425.68
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $29.88 / $72.44	Professional	26	$23.54	$29.88	$72.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.80 / $145.71 / $353.24	Professional	TC	$114.80	$145.71	$353.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.98 / $116.86 / $209.63	Professional		$21.98	$116.86	$209.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.08 / $115.46 / $283.45	Professional		$67.08	$115.46	$283.45
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.27 / $20.51 / $36.19	Professional	26	$15.27	$20.51	$36.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $83.45 / $157.25	Professional	TC	$50.18	$83.45	$157.25
United Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $101.34 / $162.33	Professional		$71.52	$101.34	$162.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $18.71 / $31.61	Professional	26	$15.61	$18.71	$31.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.34 / $81.84 / $142.85	Professional	TC	$55.34	$81.84	$142.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $90.83 / $101.23 / $144.57	Professional		$90.83	$101.23	$144.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.46 / $17.79 / $24.58	Professional	26	$15.46	$17.79	$24.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $75.37 / $83.45 / $119.99	Professional	TC	$75.37	$83.45	$119.99