Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $138.04 / $151.36	Facility	26	$114.82	$138.04	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $281.84	Professional		$169.82	$204.17	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $251.19	Professional		$125.89	$173.78	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $398.11	Professional		$158.49	$245.47	$398.11
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,513.56 / $1,513.56	Professional		$1,348.96	$1,513.56	$1,513.56
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $138.04 / $151.36	Facility	26	$114.82	$138.04	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $380.19	Professional		$169.82	$208.93	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $147.91	Professional		$30.20	$33.11	$147.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $229.09 / $549.54	Professional		$69.18	$229.09	$549.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $251.19 / $446.68	Professional		$162.18	$251.19	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $204.17 / $316.23	Professional		$154.88	$204.17	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $218.78 / $263.03	Professional		$141.25	$218.78	$263.03