Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.16 / $89.83 / $140.21	Facility	26	$69.16	$89.83	$140.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.16 / $89.83 / $171.37	Professional	26	$69.16	$89.83	$171.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $88.28 / $88.28 / $202.53	Professional	26	$88.28	$88.28	$202.53
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $102.78 / $105.06 / $114.30	Professional	26	$102.78	$105.06	$114.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.28 / $121.21 / $215.85	Professional	26	$88.28	$121.21	$215.85
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $259.18 / $529.63 / $529.63	Facility	26	$259.18	$529.63	$529.63
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $680.84 / $680.84 / $882.38	Professional	26	$680.84	$680.84	$882.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $137.09 / $173.99 / $243.65	Professional	26	$137.09	$173.99	$243.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $91.22 / $121.21 / $218.84	Professional	26	$91.22	$121.21	$218.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.25 / $116.93 / $187.90	Professional	26	$98.25	$116.93	$187.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $103.86 / $142.87	Professional	26	$90.00	$103.86	$142.87