Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $14.13 / $22.91	Facility	26	$10.96	$14.13	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $70.79	Professional		$38.02	$48.98	$70.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $19.95	Professional	26	$12.02	$15.14	$19.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $51.29	Professional	TC	$25.70	$33.88	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $29.51 / $57.54	Professional		$12.59	$29.51	$57.54
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $13.18 / $13.18	Professional	26	$12.88	$13.18	$13.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $120.23	Professional		$45.71	$67.61	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $34.67	Professional	26	$14.13	$19.95	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $47.86 / $81.28	Professional	TC	$31.62	$47.86	$81.28
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Professional		$537.03	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $109.65 / $109.65	Professional	26	$91.20	$109.65	$109.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $234.42 / $234.42	Professional	TC	$223.87	$234.42	$234.42
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.96 / $14.13	Facility	26	$8.91	$10.96	$14.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $74.13	Professional		$38.90	$51.29	$74.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.49 / $24.55	Professional	26	$12.02	$15.49	$24.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $34.67 / $53.70	Professional	TC	$26.92	$34.67	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $34.67	Professional		$32.36	$33.11	$34.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $40.74 / $89.13	Professional		$14.45	$40.74	$89.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $66.07 / $109.65	Professional		$45.71	$66.07	$109.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $31.62	Professional	26	$14.13	$19.95	$31.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $45.71 / $72.44	Professional	TC	$31.62	$45.71	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $93.33	Professional		$40.74	$56.23	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.60 / $27.54	Professional	26	$12.30	$16.60	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $39.81 / $66.07	Professional	TC	$28.84	$39.81	$66.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $39.81 / $47.86	Professional		$38.02	$39.81	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.49 / $16.22	Professional	26	$13.18	$13.49	$16.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $26.30 / $31.62	Professional	TC	$25.12	$26.30	$31.62