Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.71 / $35.94 / $55.01	Facility	26	$27.71	$35.94	$55.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $176.74 / $352.82	Professional		$137.58	$176.74	$352.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.88 / $140.80 / $279.02	Professional	TC	$109.88	$140.80	$279.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $147.43 / $211.13	Professional		$34.94	$147.43	$211.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.29 / $256.93 / $437.37	Professional		$163.29	$256.93	$437.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.00 / $206.65 / $350.20	Professional	TC	$131.00	$206.65	$350.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $101.86 / $210.24 / $210.24	Facility	26	$101.86	$210.24	$210.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,396.18 / $1,438.07 / $1,718.10	Professional		$1,396.18	$1,438.07	$1,718.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,165.91 / $1,200.89 / $1,373.85	Professional	TC	$1,165.91	$1,200.89	$1,373.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $188.68 / $326.63 / $478.94	Professional		$188.68	$326.63	$478.94
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.57 / $279.45 / $626.24	Professional	TC	$223.57	$279.45	$626.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $181.10 / $368.24	Professional		$48.90	$181.10	$368.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.25 / $260.14 / $439.16	Professional		$172.25	$260.14	$439.16
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $139.47 / $215.85 / $354.37	Professional	TC	$139.47	$215.85	$354.37
United Facility/Professional Professional Modifier Low / Median / High Price $195.10 / $230.61 / $362.24	Professional		$195.10	$230.61	$362.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.54 / $187.46 / $286.74	Professional	TC	$147.54	$187.46	$286.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $168.95 / $188.68 / $268.83	Professional		$168.95	$188.68	$268.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $133.62 / $147.93 / $212.60	Professional	TC	$133.62	$147.93	$212.60