Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.78 / $12.20 / $15.60	Facility	26	$9.78	$12.20	$15.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $96.07 / $245.35	Professional		$77.54	$96.07	$245.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $12.33 / $51.30	Professional	26	$10.07	$12.33	$51.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $83.65 / $166.62	Professional	TC	$67.75	$83.65	$166.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $12.24 / $12.24	Professional	26	$12.24	$12.24	$12.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $66.70 / $104.91	Professional		$11.55	$66.70	$104.91
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $11.03 / $11.93	Professional	26	$11.03	$11.03	$11.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $143.85 / $274.26	Professional		$83.27	$143.85	$274.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.85 / $23.90	Professional	26	$8.91	$12.85	$23.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.19 / $124.01 / $228.22	Professional	TC	$73.19	$124.01	$228.22
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.36 / $107.60 / $110.80	Facility	26	$85.36	$107.60	$110.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $876.62 / $902.92 / $902.92	Professional		$876.62	$902.92	$902.92
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $270.04 / $270.04 / $270.04	Professional	26	$270.04	$270.04	$270.04
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $820.61 / $845.22 / $845.22	Professional	TC	$820.61	$845.22	$845.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $121.30 / $160.12 / $244.42	Professional		$121.30	$160.12	$244.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.72 / $18.68 / $45.28	Professional	26	$14.72	$18.68	$45.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.44 / $141.44 / $342.88	Professional	TC	$111.44	$141.44	$342.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $253.20 / $276.80 / $355.90	Professional		$253.20	$276.80	$355.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.28 / $160.82 / $290.14	Professional		$88.28	$160.82	$290.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $12.55 / $23.69	Professional	26	$9.66	$12.55	$23.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $73.19 / $119.45 / $227.30	Professional	TC	$73.19	$119.45	$227.30
United Facility/Professional Professional Modifier Low / Median / High Price $98.03 / $131.50 / $227.16	Professional		$98.03	$131.50	$227.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $12.61 / $21.47	Professional	26	$9.99	$12.61	$21.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.69 / $113.94 / $200.95	Professional	TC	$84.69	$113.94	$200.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.82 / $92.14 / $131.85	Professional		$82.82	$92.14	$131.85
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.14 / $15.38	Professional	26	$9.66	$11.14	$15.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $73.16 / $85.52 / $1,100.00	Professional	TC	$73.16	$85.52	$1,100.00