Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $16.98 / $19.95	Facility	26	$14.13	$16.98	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $134.90	Professional		$28.84	$42.66	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.39 / $48.98	Professional	26	$15.85	$22.39	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $16.98 / $89.13	Professional	TC	$12.02	$16.98	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $37.15 / $43.65	Professional		$34.67	$37.15	$43.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $33.88 / $61.66	Professional		$19.50	$33.88	$61.66
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $20.89 / $21.38	Professional	26	$19.95	$20.89	$21.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $23.99 / $33.88	Facility	26	$5.13	$23.99	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $63.10 / $186.21	Professional		$36.31	$63.10	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $32.36 / $64.57	Professional	26	$20.42	$32.36	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.92 / $128.82	Professional	TC	$15.85	$26.92	$128.82
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $199.53 / $199.53	Facility	26	$138.04	$199.53	$199.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $204.17 / $380.19	Professional	26	$204.17	$204.17	$380.19
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	TC	$602.56	$602.56	$602.56
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $16.98 / $19.95	Facility	26	$14.13	$16.98	$19.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $128.82	Professional		$28.84	$47.86	$128.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.70 / $47.86	Professional	26	$15.85	$25.70	$47.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $20.89 / $79.43	Professional	TC	$12.02	$20.89	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $30.20 / $33.11	Professional		$13.49	$30.20	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $40.74 / $93.33	Professional		$19.05	$40.74	$93.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $23.99 / $33.88	Facility	26	$5.13	$23.99	$33.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $66.07 / $181.97	Professional		$36.31	$66.07	$181.97
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $31.62 / $60.26	Professional	26	$20.42	$31.62	$60.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.12 / $128.82	Professional	TC	$15.85	$25.12	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $169.82	Professional		$33.88	$47.86	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $50.12	Professional	26	$19.50	$26.92	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $20.42 / $123.03	Professional	TC	$14.45	$20.42	$123.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $47.86	Professional		$30.20	$39.81	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $21.38 / $25.70	Professional	26	$20.42	$21.38	$25.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.20 / $21.88	Professional	TC	$18.20	$18.20	$21.88