Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.56 / $50.72 / $93.49	Professional		$43.56	$50.72	$93.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.31 / $18.57 / $31.64	Professional	26	$14.31	$18.57	$31.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $31.57 / $60.80	Professional	TC	$27.21	$31.57	$60.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $77.91 / $77.91	Professional		$77.91	$77.91	$77.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.51 / $23.51 / $23.51	Professional	26	$23.51	$23.51	$23.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $37.06 / $108.64	Professional		$30.84	$37.06	$108.64
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $23.28 / $24.32	Professional	26	$22.96	$23.28	$24.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $41.16 / $133.75	Professional		$28.68	$41.16	$133.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $15.19 / $46.20	Professional	26	$11.64	$15.19	$46.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $28.62 / $89.68	Professional	TC	$15.19	$28.62	$89.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $123.31 / $123.31	Facility	26	$100.00	$123.31	$123.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $466.08 / $466.08 / $704.18	Professional		$466.08	$466.08	$704.18
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.58 / $186.58 / $198.23	Professional	26	$186.58	$186.58	$198.23
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.75 / $309.75 / $505.88	Professional	TC	$309.75	$309.75	$505.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.30 / $114.11 / $151.61	Professional		$70.30	$114.11	$151.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.93 / $35.90 / $55.59	Professional	26	$29.93	$35.90	$55.59
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.98 / $86.37 / $108.88	Professional	TC	$71.98	$86.37	$108.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.54 / $73.75 / $157.52	Professional		$26.54	$73.75	$157.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.35 / $57.25 / $180.52	Professional		$29.35	$57.25	$180.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $15.19 / $46.20	Professional	26	$11.59	$15.19	$46.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.30 / $29.01 / $84.31	Professional	TC	$15.30	$29.01	$84.31
United Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $47.88 / $139.30	Professional		$34.31	$47.88	$139.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $15.81 / $52.70	Professional	26	$14.60	$15.81	$52.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.01 / $25.98 / $86.60	Professional	TC	$20.01	$25.98	$86.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $42.05 / $81.47	Professional		$26.93	$42.05	$81.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $12.66 / $24.07	Professional	26	$10.28	$12.66	$24.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $29.39 / $57.40	Professional	TC	$16.42	$29.39	$57.40