Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.23 / $125.00 / $250.00	Facility	26	$106.23	$125.00	$250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.58 / $127.12 / $265.00	Professional	26	$96.58	$127.12	$265.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $96.00 / $98.43 / $134.36	Professional	26	$96.00	$98.43	$134.36
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $77.87 / $79.66 / $81.59	Professional	26	$77.87	$79.66	$81.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.22 / $105.49 / $176.71	Professional	26	$69.22	$105.49	$176.71
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $245.42 / $754.00 / $1,566.00	Facility	26	$245.42	$754.00	$1,566.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,566.00 / $2,660.92 / $2,733.83	Professional	26	$1,566.00	$2,660.92	$2,733.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.10 / $142.62 / $319.60	Professional	26	$114.10	$142.62	$319.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $73.16 / $110.93 / $185.40	Professional	26	$73.16	$110.93	$185.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.15 / $81.77 / $139.38	Professional	26	$62.15	$81.77	$139.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.19 / $78.69 / $108.65	Professional	26	$68.19	$78.69	$108.65