Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.63 / $21.73 / $38.08	Facility	26	$17.63	$21.73	$38.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.99 / $131.96 / $174.60	Professional		$101.99	$131.96	$174.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $23.05 / $31.98	Professional	26	$17.63	$23.05	$31.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.89 / $123.89 / $137.35	Professional		$123.89	$123.89	$137.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $20.14 / $21.42	Professional	26	$20.14	$20.14	$21.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $94.18 / $188.37	Professional		$21.15	$94.18	$188.37
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.43 / $33.04 / $33.04	Professional	26	$21.43	$33.04	$33.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.84 / $188.68 / $313.41	Professional		$141.84	$188.68	$313.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.75 / $30.65 / $51.72	Professional	26	$22.75	$30.65	$51.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.98 / $108.44 / $108.44	Facility	26	$52.98	$108.44	$108.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $845.52 / $845.52 / $1,121.48	Professional		$845.52	$845.52	$1,121.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $147.91 / $187.20	Professional	26	$147.91	$147.91	$187.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $129.87 / $214.29 / $252.11	Professional		$129.87	$214.29	$252.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $33.65 / $40.92	Professional	26	$27.50	$33.65	$40.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $148.21 / $182.78	Professional		$27.43	$148.21	$182.78
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $197.17 / $344.55	Professional		$142.88	$197.17	$344.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.75 / $30.49 / $45.42	Professional	26	$22.75	$30.49	$45.42
United Facility/Professional Professional Modifier Low / Median / High Price $123.45 / $165.60 / $277.06	Professional		$123.45	$165.60	$277.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $26.91 / $44.73	Professional	26	$20.23	$26.91	$44.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.60 / $122.21 / $174.15	Professional		$109.60	$122.21	$174.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $21.65 / $30.31	Professional	26	$18.78	$21.65	$30.31