Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.42 / $125.00 / $250.00	Facility	26	$111.42	$125.00	$250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.80 / $265.00	Professional	26	$100.00	$134.80	$265.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.77 / $68.29 / $140.84	Professional	26	$57.77	$68.29	$140.84
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $81.67 / $85.36 / $92.44	Professional	26	$81.67	$85.36	$92.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $106.13 / $173.81	Professional	26	$71.92	$106.13	$173.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $207.94 / $426.88 / $426.88	Facility	26	$207.94	$426.88	$426.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $554.45 / $554.45 / $692.03	Professional	26	$554.45	$554.45	$692.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $119.64 / $149.55 / $335.12	Professional	26	$119.64	$149.55	$335.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $73.73 / $110.92 / $173.81	Professional	26	$73.73	$110.92	$173.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.67 / $84.39 / $148.52	Professional	26	$65.67	$84.39	$148.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $71.50 / $82.53 / $113.94	Professional	26	$71.50	$82.53	$113.94