Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $72.20 / $243.65	Professional		$58.80	$72.20	$243.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $14.93 / $30.05	Professional	26	$11.90	$14.93	$30.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.07 / $52.66 / $91.28	Professional	TC	$42.07	$52.66	$91.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.96 / $25.77 / $28.50	Professional		$24.96	$25.77	$28.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.80 / $25.80 / $25.80	Professional	26	$25.80	$25.80	$25.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.32 / $20.32 / $20.32	Professional	TC	$20.32	$20.32	$20.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.01 / $42.78 / $128.09	Professional		$25.01	$42.78	$128.09
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $18.32 / $19.02	Professional	26	$18.14	$18.32	$19.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.83 / $51.29 / $157.94	Professional		$37.83	$51.29	$157.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.19 / $38.49	Professional	26	$9.55	$13.19	$38.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.37 / $38.45 / $122.25	Professional	TC	$26.37	$38.45	$122.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $626.79 / $626.79 / $719.55	Professional		$626.79	$626.79	$719.55
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $171.71 / $171.71 / $171.71	Professional	26	$171.71	$171.71	$171.71
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $496.32 / $496.32 / $565.28	Professional	TC	$496.32	$496.32	$565.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.81 / $124.70 / $220.81	Professional		$89.81	$124.70	$220.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.45 / $28.14 / $46.44	Professional	26	$23.45	$28.14	$46.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.45 / $102.99 / $174.37	Professional	TC	$80.45	$102.99	$174.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.32 / $73.19 / $148.44	Professional		$20.32	$73.19	$148.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $80.83 / $236.61	Professional		$38.10	$80.83	$236.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.27 / $39.65	Professional	26	$9.55	$12.27	$39.65
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.41 / $38.45 / $122.25	Professional	TC	$27.41	$38.45	$122.25
United Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $60.92 / $195.37	Professional		$47.99	$60.92	$195.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $14.26 / $46.20	Professional	26	$13.46	$14.26	$46.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.92 / $46.14 / $150.84	Professional	TC	$34.92	$46.14	$150.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $45.83 / $83.06	Professional		$34.85	$45.83	$83.06
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $10.24 / $18.88	Professional	26	$9.01	$10.24	$18.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.34 / $35.59 / $64.18	Professional	TC	$25.34	$35.59	$64.18