Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $88.48 / $268.49	Professional		$67.09	$88.48	$268.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $26.28 / $76.30	Professional	26	$20.50	$26.28	$76.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $61.84 / $202.44	Professional	TC	$48.07	$61.84	$202.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $34.79 / $34.79	Professional	26	$34.79	$34.79	$34.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $60.88 / $160.82	Professional		$40.43	$60.88	$160.82
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $29.99 / $30.31 / $31.49	Professional	26	$29.99	$30.31	$31.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.37 / $116.21 / $281.94	Professional		$53.37	$116.21	$281.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $30.77 / $84.04	Professional	26	$15.77	$30.77	$84.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.97 / $82.16 / $197.83	Professional	TC	$35.97	$82.16	$197.83
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $135.65 / $256.47 / $256.47	Facility	26	$135.65	$256.47	$256.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,150.51 / $1,210.67 / $1,210.67	Professional		$1,150.51	$1,210.67	$1,210.67
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $360.79 / $361.60 / $361.60	Professional	26	$360.79	$361.60	$361.60
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $788.91 / $914.18 / $914.18	Professional	TC	$788.91	$914.18	$914.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $124.07 / $158.66 / $252.80	Professional		$124.07	$158.66	$252.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $46.58 / $73.84	Professional	26	$38.81	$46.58	$73.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.40 / $112.08 / $178.93	Professional	TC	$93.40	$112.08	$178.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.17 / $85.88 / $189.06	Professional		$32.17	$85.88	$189.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $129.44 / $324.95	Professional		$53.71	$129.44	$324.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $30.30 / $85.26	Professional	26	$15.77	$30.30	$85.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $35.97 / $78.81 / $208.41	Professional	TC	$35.97	$78.81	$208.41
United Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $115.13 / $278.61	Professional		$65.66	$115.13	$278.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.44 / $35.72 / $80.39	Professional	26	$21.44	$35.72	$80.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.84 / $70.62 / $192.14	Professional	TC	$43.84	$70.62	$192.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.90 / $101.24 / $105.78	Professional		$44.90	$101.24	$105.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $24.10 / $31.27	Professional	26	$13.93	$24.10	$31.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.97 / $70.59 / $81.56	Professional	TC	$30.97	$70.59	$81.56