Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $93.33	Professional		$39.81	$54.95	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.50 / $42.66	Professional	26	$14.79	$19.50	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $64.57	Professional	TC	$25.12	$34.67	$64.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $43.65 / $114.82	Professional		$16.98	$43.65	$114.82
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.99	Professional	26	$23.44	$23.44	$23.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $131.83	Professional		$28.84	$42.66	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.60 / $46.77	Professional	26	$11.75	$16.60	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $28.84 / $89.13	Professional	TC	$15.14	$28.84	$89.13
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $707.95 / $707.95	Professional		$467.74	$707.95	$707.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $199.53 / $199.53	Professional	26	$186.21	$199.53	$199.53
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $501.19 / $501.19	Professional	TC	$309.03	$501.19	$501.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $72.44 / $154.88	Professional		$43.65	$72.44	$154.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $28.18 / $43.65	Professional	26	$15.14	$28.18	$43.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $69.18 / $112.20	Professional	TC	$28.84	$69.18	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $70.79	Professional		$22.91	$33.11	$70.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $85.11 / $181.97	Professional		$25.70	$85.11	$181.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $134.90	Professional		$26.92	$44.67	$134.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.45 / $45.71	Professional	26	$11.48	$14.45	$45.71
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $28.84 / $87.10	Professional	TC	$15.14	$28.84	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $138.04	Professional		$33.88	$45.71	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.60 / $52.48	Professional	26	$14.45	$16.60	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $87.10	Professional	TC	$19.05	$28.18	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $83.18	Professional		$26.92	$26.92	$83.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $23.99	Professional	26	$10.23	$10.23	$23.99
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $16.98 / $58.88	Professional	TC	$16.98	$16.98	$58.88