Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $54.95 / $61.66	Facility	26	$47.86	$54.95	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $295.12	Professional		$120.23	$165.96	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $134.90	Professional	26	$51.29	$72.44	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $169.82	Professional		$102.33	$144.54	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $134.90 / $186.21	Professional		$58.88	$134.90	$186.21
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $77.62 / $77.62	Professional	26	$70.79	$77.62	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $338.84	Professional		$134.90	$186.21	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $158.49	Professional	26	$63.10	$83.18	$158.49
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,445.44 / $1,445.44	Professional		$1,122.02	$1,445.44	$1,445.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $478.63 / $616.60 / $616.60	Professional	26	$478.63	$616.60	$616.60
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $50.12 / $61.66	Facility	26	$47.86	$50.12	$61.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $204.17 / $363.08	Professional		$128.82	$204.17	$363.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $85.11 / $151.36	Professional	26	$56.23	$85.11	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $147.91	Professional		$32.36	$51.29	$147.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $467.74	Professional		$194.98	$346.74	$467.74
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $363.08	Professional		$138.04	$181.97	$363.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $79.43 / $144.54	Professional	26	$63.10	$79.43	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $281.84	Professional		$144.54	$186.21	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $125.89	Professional	26	$64.57	$81.28	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $213.80	Professional		$169.82	$177.83	$213.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $93.33	Professional	26	$77.62	$77.62	$93.33