Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.40 / $17.05 / $20.79	Facility	26	$14.40	$17.05	$20.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $37.85 / $133.13	Professional		$27.63	$37.85	$133.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $20.46 / $37.24	Professional	26	$15.17	$20.46	$37.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.89 / $16.67 / $91.20	Professional	TC	$11.89	$16.67	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $36.15 / $36.15	Professional		$36.15	$36.15	$36.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.85 / $33.94 / $61.19	Professional		$18.85	$33.94	$61.19
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $20.72 / $21.32	Professional	26	$19.78	$20.72	$21.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $58.23 / $183.39	Professional		$36.15	$58.23	$183.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.97 / $30.97 / $61.05	Professional	26	$19.97	$30.97	$61.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $24.62 / $125.76	Professional	TC	$16.20	$24.62	$125.76
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $201.45 / $201.45	Facility	26	$100.00	$201.45	$201.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $764.92 / $787.87 / $787.87	Professional		$764.92	$787.87	$787.87
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $203.00 / $382.94 / $382.94	Professional	26	$203.00	$382.94	$382.94
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $585.86 / $603.44 / $603.44	Professional	TC	$585.86	$603.44	$603.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.84 / $61.91 / $79.89	Professional		$47.84	$61.91	$79.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.49 / $33.63 / $43.08	Professional	26	$26.49	$33.63	$43.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $28.28 / $36.82	Professional	TC	$22.28	$28.28	$36.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $31.50 / $67.43	Professional		$19.82	$31.50	$67.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $64.22 / $171.35	Professional		$36.95	$64.22	$171.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $30.97 / $61.05	Professional	26	$20.44	$30.97	$61.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $24.38 / $128.41	Professional	TC	$16.20	$24.38	$128.41
United Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $46.17 / $159.30	Professional		$33.35	$46.17	$159.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $26.45 / $49.04	Professional	26	$19.30	$26.45	$49.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.10 / $19.32 / $114.79	Professional	TC	$14.10	$19.32	$114.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $36.15 / $50.96	Professional		$32.02	$36.15	$50.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $19.97 / $27.72	Professional	26	$17.39	$19.97	$27.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.63 / $16.20 / $23.25	Professional	TC	$14.63	$16.20	$23.25