Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.72 / $46.34 / $71.59	Facility	26	$35.72	$46.34	$71.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.05 / $278.52 / $507.59	Professional		$217.05	$278.52	$507.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $46.84 / $93.01	Professional	26	$35.72	$46.84	$93.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.32 / $232.19 / $488.08	Professional	TC	$181.32	$232.19	$488.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.55 / $86.71 / $102.48	Professional	26	$52.55	$86.71	$102.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.67 / $241.24 / $342.98	Professional		$45.67	$241.24	$342.98
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $52.01 / $53.52 / $58.57	Professional	26	$52.01	$53.52	$58.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.42 / $395.29 / $668.54	Professional		$251.42	$395.29	$668.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.97 / $67.62 / $110.13	Professional	26	$45.97	$67.62	$110.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.82 / $330.75 / $564.27	Professional	TC	$212.82	$330.75	$564.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $131.71 / $270.80 / $270.80	Facility	26	$131.71	$270.80	$270.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,141.04 / $2,141.04 / $2,645.93	Professional		$2,141.04	$2,141.04	$2,645.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $351.55 / $351.55 / $443.25	Professional	26	$351.55	$351.55	$443.25
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,789.49 / $1,789.49 / $2,202.67	Professional	TC	$1,789.49	$1,789.49	$2,202.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $290.05 / $502.76 / $754.58	Professional		$290.05	$502.76	$754.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $95.27 / $213.48	Professional	26	$76.20	$95.27	$213.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $358.90 / $448.62 / $1,005.32	Professional	TC	$358.90	$448.62	$1,005.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.82 / $433.49 / $535.85	Professional		$88.82	$433.49	$535.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $264.48 / $399.40 / $670.36	Professional		$264.48	$399.40	$670.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $46.93 / $70.28 / $110.13	Professional	26	$46.93	$70.28	$110.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $226.62 / $343.59 / $570.77	Professional	TC	$226.62	$343.59	$570.77
United Facility/Professional Professional Modifier Low / Median / High Price $292.18 / $361.82 / $560.16	Professional		$292.18	$361.82	$560.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $59.33 / $89.69	Professional	26	$47.93	$59.33	$89.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.25 / $305.32 / $470.47	Professional	TC	$244.25	$305.32	$470.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $260.05 / $290.05 / $413.92	Professional		$260.05	$290.05	$413.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.55 / $52.55 / $72.48	Professional	26	$45.55	$52.55	$72.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $214.50 / $237.49 / $341.44	Professional	TC	$214.50	$237.49	$341.44