Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $30.90 / $45.71	Facility	26	$28.84	$30.90	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $125.89	Professional		$79.43	$89.13	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $32.36 / $50.12	Professional	26	$28.18	$32.36	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Professional	26	$26.92	$26.92	$26.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $67.61 / $123.03	Professional		$28.18	$67.61	$123.03
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $30.90 / $30.90	Professional	26	$29.51	$30.90	$30.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $35.48 / $51.29	Facility	26	$7.59	$35.48	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $186.21	Professional		$87.10	$117.49	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $41.69 / $69.18	Professional	26	$31.62	$41.69	$69.18
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $741.31 / $741.31	Professional		$562.34	$741.31	$741.31
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $245.47 / $245.47	Professional	26	$199.53	$245.47	$245.47
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $30.90 / $45.71	Facility	26	$23.99	$30.90	$45.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $165.96	Professional		$79.43	$100.00	$165.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $33.88 / $57.54	Professional	26	$28.84	$33.88	$57.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $72.44	Professional		$26.30	$33.11	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $95.50 / $204.17	Professional		$33.11	$95.50	$204.17
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Facility	26	$51.29	$51.29	$51.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $199.53	Professional		$87.10	$117.49	$199.53
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $63.10	Professional	26	$30.90	$40.74	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $158.49	Professional		$74.13	$100.00	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $36.31 / $57.54	Professional	26	$27.54	$36.31	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $112.20	Professional		$69.18	$89.13	$112.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $38.02	Professional	26	$23.99	$30.90	$38.02