Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.50 / $134.25 / $250.00	Facility	26	$112.50	$134.25	$250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.56 / $155.00 / $291.50	Professional	26	$103.56	$155.00	$291.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $134.66 / $164.59 / $186.98	Professional	26	$134.66	$164.59	$186.98
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $94.89 / $97.48 / $106.25	Professional	26	$94.89	$97.48	$106.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.34 / $125.12 / $203.60	Professional	26	$83.34	$125.12	$203.60
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $780.00 / $924.96 / $945.52	Facility	26	$780.00	$924.96	$945.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,192.32 / $1,192.32 / $1,192.32	Professional	26	$1,192.32	$1,192.32	$1,192.32
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $139.03 / $173.79 / $389.44	Professional	26	$139.03	$173.79	$389.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $88.24 / $129.68 / $203.75	Professional	26	$88.24	$129.68	$203.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.04 / $92.34 / $179.24	Professional	26	$76.04	$92.34	$179.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $95.89 / $132.18	Professional	26	$83.09	$95.89	$132.18