Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.72 / $11.90 / $21.00	Facility	26	$9.72	$11.90	$21.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $43.33 / $66.31	Professional		$26.23	$43.33	$66.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $15.12 / $22.27	Professional	26	$12.00	$15.12	$22.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.47 / $28.39 / $43.59	Professional	TC	$12.47	$28.39	$43.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $42.54 / $42.54	Professional		$42.54	$42.54	$42.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $16.32 / $16.32	Professional	26	$16.32	$16.32	$16.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $33.83 / $62.75	Professional		$12.59	$33.83	$62.75
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $13.79 / $14.18	Professional	26	$13.79	$13.79	$14.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.32 / $48.58 / $82.40	Professional		$31.32	$48.58	$82.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $19.73 / $32.00	Professional	26	$14.60	$19.73	$32.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.05 / $28.39 / $52.16	Professional	TC	$14.05	$28.39	$52.16
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.90 / $71.11 / $80.00	Facility	26	$33.90	$71.11	$80.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $306.10 / $306.10 / $371.25	Professional		$306.10	$306.10	$371.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.99 / $93.99 / $115.50	Professional	26	$93.99	$93.99	$115.50
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $212.11 / $212.11 / $255.75	Professional	TC	$212.11	$212.11	$255.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $60.23 / $83.89	Professional		$48.18	$60.23	$83.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $19.47 / $27.12	Professional	26	$16.32	$19.47	$27.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $40.75 / $56.76	Professional	TC	$34.15	$40.75	$56.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $45.93 / $79.70	Professional		$17.64	$45.93	$79.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $50.16 / $90.35	Professional		$32.14	$50.16	$90.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $19.39 / $30.48	Professional	26	$14.60	$19.39	$30.48
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $13.69 / $28.20 / $47.05	Professional	TC	$13.69	$28.20	$47.05
United Facility/Professional Professional Modifier Low / Median / High Price $23.43 / $34.97 / $56.11	Professional		$23.43	$34.97	$56.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $15.88 / $24.64	Professional	26	$11.91	$15.88	$24.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.95 / $19.17 / $34.44	Professional	TC	$10.95	$19.17	$34.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $41.18 / $58.43	Professional		$36.72	$41.18	$58.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.87 / $13.67 / $18.89	Professional	26	$11.87	$13.67	$18.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $27.51 / $39.51	Professional	TC	$24.84	$27.51	$39.51