Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $89.13 / $120.23	Facility	26	$57.54	$89.13	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $707.95	Professional		$346.74	$478.63	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $147.91	Professional	26	$57.54	$89.13	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $338.84 / $407.38	Professional		$57.54	$338.84	$407.38
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $70.79	Professional	26	$66.07	$66.07	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $426.58 / $758.58	Professional		$331.13	$426.58	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $131.83	Professional	26	$56.23	$74.13	$131.83
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	26	$645.65	$645.65	$645.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,467.37 / $3,467.37	Professional		$2,754.23	$3,467.37	$3,467.37
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $562.34 / $562.34	Professional	26	$436.52	$562.34	$562.34
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $72.44 / $120.23	Facility	26	$57.54	$72.44	$120.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $588.84 / $812.83	Professional		$398.11	$588.84	$812.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $104.71 / $147.91	Professional	26	$69.18	$104.71	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $331.13	Professional		$32.36	$33.11	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $870.96 / $1,174.90	Professional		$794.33	$870.96	$1,174.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $776.25	Professional		$338.84	$426.58	$776.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $72.44 / $131.83	Professional	26	$58.88	$72.44	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $416.87 / $660.69	Professional		$354.81	$416.87	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $74.13 / $112.20	Professional	26	$60.26	$74.13	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $426.58 / $426.58	Professional		$407.38	$426.58	$426.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $70.79 / $70.79	Professional	26	$69.18	$70.79	$70.79