Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.23 / $24.76 / $38.43	Facility	26	$19.23	$24.76	$38.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $70.01 / $119.78	Professional		$44.88	$70.01	$119.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $26.28 / $47.91	Professional	26	$20.16	$26.28	$47.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.44 / $27.84 / $50.54	Professional	52	$22.44	$27.84	$50.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.11 / $35.56 / $65.80	Professional	TC	$24.11	$35.56	$65.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.74 / $47.56 / $61.67	Professional		$22.74	$47.56	$61.67
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $28.22 / $30.04	Professional	26	$28.22	$28.22	$30.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.64 / $76.93 / $145.47	Professional		$54.64	$76.93	$145.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.05 / $31.29 / $58.30	Professional	26	$24.05	$31.29	$58.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.61 / $44.08 / $89.96	Professional	TC	$29.61	$44.08	$89.96
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.53 / $151.72 / $151.72	Facility	26	$78.53	$151.72	$151.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $497.00 / $497.00 / $566.17	Professional		$497.00	$497.00	$566.17
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $320.31 / $320.31 / $320.31	Professional	26	$320.31	$320.31	$320.31
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $320.31 / $320.31 / $323.63	Professional	TC	$320.31	$320.31	$323.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.31 / $98.99 / $150.77	Professional		$63.31	$98.99	$150.77
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $43.67 / $116.44	Professional	26	$34.15	$43.67	$116.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.26 / $55.32 / $147.52	Professional	TC	$43.26	$55.32	$147.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $163.10 / $196.50	Professional		$96.30	$163.10	$196.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $78.12 / $164.62	Professional		$55.33	$78.12	$164.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.05 / $30.29 / $56.69	Professional	26	$24.05	$30.29	$56.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.62 / $41.88 / $89.15	Professional	TC	$29.62	$41.88	$89.15
United Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $79.76 / $116.82	Professional		$57.67	$79.76	$116.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.41 / $32.04 / $48.11	Professional	26	$25.41	$32.04	$48.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.40 / $46.12 / $65.88	Professional	TC	$31.40	$46.12	$65.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $63.31 / $89.68	Professional		$56.32	$63.31	$89.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.84 / $28.47 / $39.86	Professional	26	$24.84	$28.47	$39.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.48 / $34.84 / $50.07	Professional	TC	$31.48	$34.84	$50.07