Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.55 / $21.99 / $41.05	Facility	26	$20.55	$21.99	$41.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.07 / $70.69 / $128.31	Professional		$49.07	$70.69	$128.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.55 / $27.95 / $51.26	Professional	26	$20.55	$27.95	$51.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $38.83 / $73.33	Professional	TC	$28.51	$38.83	$73.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $53.01 / $68.72	Professional		$24.77	$53.01	$68.72
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.14 / $30.14 / $31.89	Professional	26	$30.14	$30.14	$31.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Facility	26	$36.24	$36.24	$36.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $93.11 / $178.48	Professional		$61.90	$93.11	$178.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.16 / $35.50 / $66.84	Professional	26	$26.16	$35.50	$66.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.13 / $56.20 / $109.66	Professional	TC	$35.13	$56.20	$109.66
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $93.26 / $161.31 / $161.31	Facility	26	$93.26	$161.31	$161.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $583.91 / $603.17 / $618.45	Professional		$583.91	$603.17	$618.45
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $335.18 / $335.18 / $335.18	Professional	26	$335.18	$335.18	$335.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $353.01 / $360.07 / $360.45	Professional	TC	$353.01	$360.07	$360.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $108.20 / $170.57	Professional		$69.23	$108.20	$170.57
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.42 / $46.58 / $124.20	Professional	26	$36.42	$46.58	$124.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.19 / $61.62 / $164.32	Professional	TC	$48.19	$61.62	$164.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $133.19 / $185.10 / $223.00	Professional		$133.19	$185.10	$223.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Facility	26	$36.24	$36.24	$36.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $93.81 / $190.66	Professional		$61.90	$93.81	$190.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.68 / $33.97 / $63.97	Professional	26	$26.68	$33.97	$63.97
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $35.13 / $55.73 / $103.34	Professional	TC	$35.13	$55.73	$103.34
United Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $98.81 / $156.43	Professional		$76.06	$98.81	$156.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $36.72 / $55.69	Professional	26	$27.61	$36.72	$55.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.12 / $62.95 / $96.90	Professional	TC	$48.12	$62.95	$96.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $69.23 / $98.05	Professional		$61.56	$69.23	$98.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.50 / $30.41 / $42.57	Professional	26	$26.50	$30.41	$42.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.06 / $38.82 / $55.80	Professional	TC	$35.06	$38.82	$55.80