Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $30.90 / $40.74	Facility	26	$26.92	$30.90	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $194.98 / $309.03	Professional		$154.88	$194.98	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $158.49 / $251.19	Professional	TC	$123.03	$158.49	$251.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $165.96 / $213.80	Professional		$37.15	$165.96	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $467.74	Professional		$173.78	$275.42	$467.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $218.78 / $363.08	Professional	TC	$138.04	$218.78	$363.08
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	26	$275.42	$275.42	$275.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,737.80 / $1,737.80	Professional		$1,445.44	$1,737.80	$1,737.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,380.38 / $1,380.38	Professional	TC	$1,202.26	$1,380.38	$1,380.38
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $30.90 / $34.67	Facility	26	$26.92	$30.90	$34.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $478.63	Professional		$162.18	$263.03	$478.63
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $208.93 / $380.19	Professional	TC	$123.03	$208.93	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $436.52	Professional		$173.78	$251.19	$436.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $208.93 / $346.74	Professional	TC	$138.04	$208.93	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $229.09 / $363.08	Professional		$186.21	$229.09	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $186.21 / $288.40	Professional	TC	$151.36	$186.21	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $204.17	Professional		$194.98	$194.98	$204.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $162.18	Professional	TC	$151.36	$151.36	$162.18