Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $12.88 / $14.13	Facility	26	$10.00	$12.88	$14.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $51.29 / $81.28	Professional		$43.65	$51.29	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $40.74 / $69.18	Professional		$12.88	$40.74	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.47 / $16.22 / $22.91	Facility	26	$3.47	$16.22	$22.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $109.65	Professional		$50.12	$67.61	$109.65
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $12.59 / $14.13	Facility	26	$10.00	$12.59	$14.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $102.33	Professional		$43.65	$57.54	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $32.36 / $40.74	Professional		$11.75	$32.36	$40.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $58.88 / $125.89	Professional		$15.85	$58.88	$125.89
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $22.91	Facility	26	$22.91	$22.91	$22.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $117.49	Professional		$48.98	$69.18	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $91.20	Professional		$43.65	$58.88	$91.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $69.18	Professional		$41.69	$54.95	$69.18