Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.96 / $145.85 / $175.00	Facility	26	$112.96	$145.85	$175.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.31 / $155.00 / $374.89	Professional	26	$113.31	$155.00	$374.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.43 / $151.46 / $210.67	Professional	26	$86.43	$151.46	$210.67
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $103.81 / $103.81 / $112.19	Professional	26	$103.81	$103.81	$112.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.70 / $140.50 / $230.27	Professional	26	$93.70	$140.50	$230.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $827.12 / $1,042.72 / $1,063.59	Facility	26	$827.12	$1,042.72	$1,063.59
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 $156.58 / $195.73 / $438.60	Professional	26	$156.58	$195.73	$438.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $99.21 / $145.84 / $230.56	Professional	26	$99.21	$145.84	$230.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.89 / $102.93 / $190.68	Professional	26	$85.89	$102.93	$190.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $93.58 / $108.04 / $148.94	Professional	26	$93.58	$108.04	$148.94