Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.70 / $47.86	Professional		$20.89	$25.70	$47.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.89 / $26.92	Professional	26	$16.98	$20.89	$26.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $25.70	Professional	TC	$3.02	$3.98	$25.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.99 / $31.62	Professional		$23.44	$23.99	$31.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Professional	26	$22.39	$22.39	$22.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $17.38 / $20.42	Professional		$15.14	$17.38	$20.42
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.95 / $19.95	Professional	26	$19.50	$19.95	$19.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $69.18	Professional		$20.89	$30.90	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.44 / $35.48	Professional	26	$17.38	$23.44	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.82 / $5.25 / $39.81	Professional	TC	$2.82	$5.25	$39.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $323.59	Professional		$302.00	$302.00	$323.59
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $165.96 / $165.96	Professional	26	$158.49	$165.96	$165.96
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $223.87	Professional	TC	$186.21	$186.21	$223.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $44.67	Professional		$19.95	$25.70	$44.67
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $31.62	Professional	26	$15.85	$20.89	$31.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $7.94	Professional	TC	$3.02	$3.98	$7.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $20.89 / $33.11	Professional		$3.47	$20.89	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.27 / $22.39 / $48.98	Professional		$4.27	$22.39	$48.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $69.18	Professional		$21.38	$32.36	$69.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.44 / $40.74	Professional	26	$17.38	$23.44	$40.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $2.82 / $5.37 / $40.74	Professional	TC	$2.82	$5.37	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.18 / $63.10	Professional		$19.05	$28.18	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.50 / $29.51	Professional	26	$15.85	$19.50	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.95 / $4.79 / $40.74	Professional	TC	$2.95	$4.79	$40.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $25.12	Professional		$23.99	$23.99	$25.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.95 / $20.42	Professional	26	$19.50	$19.95	$20.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $4.37 / $4.47	Professional	TC	$4.07	$4.37	$4.47