Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.66 / $180.87 / $613.71	Professional		$143.66	$180.87	$613.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.84 / $88.89 / $172.40	Professional	26	$72.84	$88.89	$172.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.78 / $79.52 / $179.03	Professional	TC	$70.78	$79.52	$179.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.83 / $72.45 / $77.98	Professional		$70.83	$72.45	$77.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.36 / $170.31 / $329.23	Professional		$129.36	$170.31	$329.23
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $110.55 / $111.61 / $113.83	Professional	26	$110.55	$111.61	$113.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.66 / $146.74 / $439.82	Professional		$109.66	$146.74	$439.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.83 / $86.52 / $219.74	Professional	26	$57.83	$86.52	$219.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.15 / $74.95 / $216.25	Professional	TC	$47.15	$74.95	$216.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $328.00 / $581.40 / $581.40	Facility	26	$328.00	$581.40	$581.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.81 / $1,548.81 / $1,941.23	Professional		$1,548.81	$1,548.81	$1,941.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $832.85 / $836.46 / $931.13	Professional	26	$832.85	$836.46	$931.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $785.37 / $806.89 / $1,010.10	Professional	TC	$785.37	$806.89	$1,010.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $224.58 / $343.52 / $548.22	Professional		$224.58	$343.52	$548.22
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $142.72 / $171.27 / $284.02	Professional	26	$142.72	$171.27	$284.02
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.54 / $172.25 / $264.22	Professional	TC	$143.54	$172.25	$264.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.25 / $171.09 / $420.07	Professional		$101.25	$171.09	$420.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.50 / $224.75 / $599.71	Professional		$114.50	$224.75	$599.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.83 / $77.36 / $223.87	Professional	26	$57.83	$77.36	$223.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $47.07 / $74.95 / $215.88	Professional	TC	$47.07	$74.95	$215.88
United Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $171.79 / $480.72	Professional		$135.22	$171.79	$480.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.18 / $84.14 / $275.22	Professional	26	$76.18	$84.14	$275.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.46 / $87.83 / $212.94	Professional	TC	$57.46	$87.83	$212.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $121.99 / $229.55	Professional		$93.74	$121.99	$229.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $61.68 / $115.10	Professional	26	$51.84	$61.68	$115.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.52 / $60.30 / $114.45	Professional	TC	$41.52	$60.30	$114.45