Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.86 / $339.37 / $518.52	Professional		$261.86	$339.37	$518.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.18 / $35.43 / $57.83	Professional	26	$27.18	$35.43	$57.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.33 / $301.10 / $467.01	Professional	TC	$234.33	$301.10	$467.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.67 / $177.67 / $177.67	Professional		$177.67	$177.67	$177.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $89.67 / $593.95	Professional		$58.35	$89.67	$593.95
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $43.87 / $44.42 / $46.08	Professional	26	$43.87	$44.42	$46.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.39 / $279.61 / $799.75	Professional		$184.39	$279.61	$799.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.93 / $29.12 / $88.09	Professional	26	$22.93	$29.12	$88.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.30 / $254.82 / $708.93	Professional	TC	$164.30	$254.82	$708.93
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $114.94 / $233.75 / $233.75	Facility	26	$114.94	$233.75	$233.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,779.34 / $2,779.34 / $3,419.93	Professional		$2,779.34	$2,779.34	$3,419.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $306.82 / $306.82 / $376.73	Professional	26	$306.82	$306.82	$376.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,481.83 / $2,481.83 / $3,043.20	Professional	TC	$2,481.83	$2,481.83	$3,043.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $491.66 / $590.00 / $976.91	Professional		$491.66	$590.00	$976.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.01 / $68.42 / $105.84	Professional	26	$57.01	$68.42	$105.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $434.65 / $521.58 / $871.07	Professional	TC	$434.65	$521.58	$871.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.97 / $379.61 / $754.52	Professional		$49.97	$379.61	$754.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $186.73 / $407.94 / $1,078.58	Professional		$186.73	$407.94	$1,078.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $29.12 / $86.68	Professional	26	$22.91	$29.12	$86.68
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $159.72 / $254.82 / $719.47	Professional	TC	$159.72	$254.82	$719.47
United Facility/Professional Professional Modifier Low / Median / High Price $257.87 / $332.26 / $900.80	Professional		$257.87	$332.26	$900.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $31.32 / $101.78	Professional	26	$30.53	$31.32	$101.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.72 / $303.98 / $799.02	Professional	TC	$226.72	$303.98	$799.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $175.66 / $216.72 / $392.84	Professional		$175.66	$216.72	$392.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $24.28 / $45.88	Professional	26	$19.85	$24.28	$45.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $155.81 / $195.84 / $346.97	Professional	TC	$155.81	$195.84	$346.97