Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.56 / $13.74 / $21.78	Facility	26	$10.56	$13.74	$21.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $41.06 / $70.22	Professional		$30.49	$41.06	$70.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $14.64 / $24.99	Professional	26	$11.12	$14.64	$24.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $25.71 / $45.57	Professional	TC	$19.93	$25.71	$45.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.12 / $25.67 / $25.67	Professional	26	$17.12	$25.67	$25.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $33.36 / $55.08	Professional		$13.46	$33.36	$55.08
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $15.41 / $15.41 / $16.75	Professional	26	$15.41	$15.41	$16.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $47.89 / $85.41	Professional		$33.61	$47.89	$85.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $17.88 / $32.08	Professional	26	$13.09	$17.88	$32.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $30.51 / $57.10	Professional	TC	$20.23	$30.51	$57.10
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.72 / $80.66 / $80.66	Facility	26	$41.72	$80.66	$80.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $301.08 / $301.08 / $388.65	Professional		$301.08	$301.08	$388.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.20 / $104.20 / $132.90	Professional	26	$104.20	$104.20	$132.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.89 / $196.89 / $255.75	Professional	TC	$196.89	$196.89	$255.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.20 / $74.18 / $136.50	Professional		$56.20	$74.18	$136.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $26.15 / $63.40	Professional	26	$20.61	$26.15	$63.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.84 / $48.03 / $116.44	Professional	TC	$37.84	$48.03	$116.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.50 / $92.10 / $126.30	Professional		$76.50	$92.10	$126.30
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.02 / $114.54	Professional		$33.88	$54.02	$114.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $17.52 / $31.44	Professional	26	$13.22	$17.52	$31.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $29.39 / $55.73	Professional	TC	$20.17	$29.39	$55.73
United Facility/Professional Professional Modifier Low / Median / High Price $34.92 / $45.53 / $74.50	Professional		$34.92	$45.53	$74.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $16.80 / $27.78	Professional	26	$13.75	$16.80	$27.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.05 / $28.88 / $47.30	Professional	TC	$20.05	$28.88	$47.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $43.07 / $61.01	Professional		$38.36	$43.07	$61.01
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $15.56 / $21.49	Professional	26	$13.53	$15.56	$21.49
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $27.51 / $39.51	Professional	TC	$24.84	$27.51	$39.51