Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $125.89 / $165.96	Facility	26	$112.20	$125.89	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $151.36 / $380.19	Professional	26	$100.00	$151.36	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $151.36 / $213.80	Professional	26	$85.11	$151.36	$213.80
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $112.20 / $112.20	Professional	26	$107.15	$112.20	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $141.25 / $239.88	Professional	26	$95.50	$141.25	$239.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility	26	$1,047.13	$1,047.13	$1,047.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional	26	$1,202.26	$1,202.26	$1,202.26
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $125.89 / $165.96	Facility	26	$112.20	$125.89	$165.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $204.17 / $446.68	Professional	26	$114.82	$204.17	$446.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $131.83 / $229.09	Professional	26	$95.50	$131.83	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $194.98	Professional	26	$85.11	$104.71	$194.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $109.65 / $112.20	Professional	26	$109.65	$109.65	$112.20