Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.01 / $34.34 / $60.50	Facility	26	$28.01	$34.34	$60.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $268.44 / $417.48	Professional		$204.05	$268.44	$417.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.22 / $36.85 / $53.98	Professional	26	$30.22	$36.85	$53.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.83 / $227.88 / $324.75	Professional	TC	$173.83	$227.88	$324.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.15 / $232.17 / $290.33	Professional		$215.15	$232.17	$290.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.98 / $35.22 / $53.88	Professional	26	$8.98	$35.22	$53.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.17 / $176.48 / $338.30	Professional		$32.17	$176.48	$338.30
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.56 / $51.69 / $51.69	Professional	26	$35.56	$51.69	$51.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.62 / $324.04 / $538.77	Professional		$240.62	$324.04	$538.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $48.63 / $80.59	Professional	26	$36.78	$48.63	$80.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.30 / $274.31 / $457.76	Professional	TC	$203.30	$274.31	$457.76
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $86.46 / $178.55 / $178.55	Facility	26	$86.46	$178.55	$178.55
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,627.28 / $1,627.28 / $2,088.23	Professional		$1,627.28	$1,627.28	$2,088.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $234.31 / $234.31 / $315.52	Professional	26	$234.31	$234.31	$315.52
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,392.98 / $1,392.98 / $1,772.70	Professional	TC	$1,392.98	$1,392.98	$1,772.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $226.95 / $358.08 / $429.70	Professional		$226.95	$358.08	$429.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.69 / $55.92 / $67.98	Professional	26	$45.69	$55.92	$67.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $252.71 / $309.32 / $376.04	Professional	TC	$252.71	$309.32	$376.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $253.89 / $312.49	Professional		$45.20	$253.89	$312.49
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $243.21 / $337.08 / $596.30	Professional		$243.21	$337.08	$596.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $48.63 / $72.15	Professional	26	$36.78	$48.63	$72.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $203.30 / $272.22 / $414.19	Professional	TC	$203.30	$272.22	$414.19
United Facility/Professional Professional Modifier Low / Median / High Price $212.73 / $289.94 / $474.40	Professional		$212.73	$289.94	$474.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $41.69 / $69.31	Professional	26	$31.76	$41.69	$69.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.89 / $243.65 / $399.75	Professional	TC	$183.89	$243.65	$399.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $203.74 / $226.95 / $323.70	Professional		$203.74	$226.95	$323.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $35.92 / $50.29	Professional	26	$31.19	$35.92	$50.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $172.55 / $191.03 / $274.60	Professional	TC	$172.55	$191.03	$274.60