Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.51 / $53.43 / $96.14	Facility	26	$44.51	$53.43	$96.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.86 / $161.49 / $280.63	Professional		$128.86	$161.49	$280.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.51 / $58.00 / $90.03	Professional	26	$44.51	$58.00	$90.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.36 / $103.93 / $190.10	Professional	TC	$84.36	$103.93	$190.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.31 / $115.99 / $241.45	Professional		$46.31	$115.99	$241.45
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $54.39 / $57.56 / $57.56	Professional	26	$54.39	$57.56	$57.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $66.70	Facility	26	$66.70	$66.70	$66.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.12 / $389.85 / $631.59	Professional		$286.12	$389.85	$631.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.61 / $74.34 / $120.72	Professional	26	$56.61	$74.34	$120.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.94 / $322.10 / $509.16	Professional	TC	$225.94	$322.10	$509.16
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $134.77 / $286.66 / $286.66	Facility	26	$134.77	$286.66	$286.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,432.95 / $1,731.57 / $1,779.01	Professional		$1,432.95	$1,731.57	$1,779.01
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $367.94 / $367.94 / $467.10	Professional	26	$367.94	$367.94	$467.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,115.23 / $1,410.54 / $1,449.19	Professional	TC	$1,115.23	$1,410.54	$1,449.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $312.05 / $425.52 / $718.01	Professional		$312.05	$425.52	$718.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.64 / $89.54 / $131.74	Professional	26	$65.64	$89.54	$131.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $284.64 / $364.35 / $910.88	Professional	TC	$284.64	$364.35	$910.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.34 / $282.12 / $471.41	Professional		$62.34	$282.12	$471.41
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $66.70	Facility	26	$66.70	$66.70	$66.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $291.74 / $407.09 / $713.44	Professional		$291.74	$407.09	$713.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.61 / $74.34 / $110.68	Professional	26	$56.61	$74.34	$110.68
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $228.93 / $320.50 / $486.83	Professional	TC	$228.93	$320.50	$486.83
United Facility/Professional Professional Modifier Low / Median / High Price $254.36 / $333.85 / $540.52	Professional		$254.36	$333.85	$540.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.05 / $104.91	Professional	26	$47.86	$64.05	$104.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.99 / $270.60 / $431.99	Professional	TC	$204.99	$270.60	$431.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.59 / $155.47 / $220.55	Professional		$138.59	$155.47	$220.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $47.76 / $54.91 / $76.87	Professional	26	$47.76	$54.91	$76.87
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $90.83 / $100.56 / $144.56	Professional	TC	$90.83	$100.56	$144.56