Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.01 / $5.31 / $9.61	Facility	26	$4.01	$5.31	$9.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $6.43 / $26.60	Professional	26	$5.01	$6.43	$26.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.72 / $20.53 / $78.81	Professional	TC	$15.72	$20.53	$78.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $27.88 / $30.00	Professional	26	$23.23	$27.88	$30.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $23.60 / $24.10	Professional	26	$23.60	$23.60	$24.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.25 / $32.71 / $53.63	Professional	26	$24.25	$32.71	$53.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.80 / $102.17 / $166.79	Professional	TC	$76.80	$102.17	$166.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.75 / $110.49 / $120.22	Facility	26	$57.75	$110.49	$120.22
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.16 / $149.40 / $196.13	Professional	26	$145.16	$149.40	$196.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $393.12 / $393.12 / $650.17	Professional	TC	$393.12	$393.12	$650.17
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.69 / $33.04 / $43.91	Professional	26	$27.69	$33.04	$43.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.88 / $103.70 / $137.77	Professional	TC	$86.88	$103.70	$137.77
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.25 / $32.29 / $52.37	Professional	26	$24.25	$32.29	$52.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $76.80 / $101.00 / $157.65	Professional	TC	$76.80	$101.00	$157.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $21.14 / $31.83	Professional	26	$15.31	$21.14	$31.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.06 / $67.19 / $101.17	Professional	TC	$54.06	$67.19	$101.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $23.23 / $32.08	Professional	26	$20.14	$23.23	$32.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.00 / $69.98 / $100.59	Professional	TC	$61.00	$69.98	$100.59