Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.00 / $33.04 / $54.70	Facility	26	$28.00	$33.04	$54.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.89 / $133.56 / $221.12	Professional		$84.89	$133.56	$221.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.02 / $41.01 / $64.41	Professional	26	$30.02	$41.01	$64.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.89 / $83.11 / $143.19	Professional	TC	$56.89	$83.11	$143.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.19 / $97.01 / $178.59	Professional		$33.19	$97.01	$178.59
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.61 / $58.10 / $58.10	Professional	26	$40.61	$58.10	$58.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.79 / $159.00 / $253.54	Professional		$106.79	$159.00	$253.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $54.95 / $87.49	Professional	26	$38.67	$54.95	$87.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.81 / $106.07 / $172.72	Professional	TC	$63.81	$106.07	$172.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $214.20 / $214.20	Facility	26	$100.00	$214.20	$214.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $802.94 / $834.21 / $1,319.18	Professional		$802.94	$834.21	$1,319.18
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $261.89 / $261.89 / $336.38	Professional	26	$261.89	$261.89	$336.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $595.82 / $595.82 / $982.73	Professional	TC	$595.82	$595.82	$982.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.67 / $251.92 / $280.95	Professional		$194.67	$251.92	$280.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.56 / $66.70 / $83.85	Professional	26	$52.56	$66.70	$83.85
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $145.91 / $176.16 / $202.03	Professional	TC	$145.91	$176.16	$202.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.23 / $159.10 / $255.39	Professional		$50.23	$159.10	$255.39
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.24 / $176.71 / $331.55	Professional		$114.24	$176.71	$331.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.08 / $55.56 / $84.88	Professional	26	$39.08	$55.56	$84.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $64.18 / $106.07 / $172.72	Professional	TC	$64.18	$106.07	$172.72
United Facility/Professional Professional Modifier Low / Median / High Price $88.67 / $118.11 / $203.49	Professional		$88.67	$118.11	$203.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.92 / $46.23 / $75.23	Professional	26	$35.92	$46.23	$75.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.01 / $72.50 / $120.83	Professional	TC	$49.01	$72.50	$120.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.31 / $145.61 / $207.58	Professional		$130.31	$145.61	$207.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $34.51 / $39.54 / $55.04	Professional	26	$34.51	$39.54	$55.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $95.79 / $106.07 / $152.54	Professional	TC	$95.79	$106.07	$152.54