Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.21 / $24.14 / $30.49	Facility	26	$20.21	$24.14	$30.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.20 / $156.53 / $198.66	Professional		$121.20	$156.53	$198.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.58 / $128.18 / $169.43	Professional	TC	$99.58	$128.18	$169.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $117.65 / $219.48	Professional		$21.15	$117.65	$219.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.73 / $185.82 / $301.02	Professional		$109.73	$185.82	$301.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.10 / $155.10 / $248.45	Professional	TC	$98.10	$155.10	$248.45
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $76.12 / $132.62 / $132.62	Facility	26	$76.12	$132.62	$132.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $964.87 / $964.87 / $1,490.25	Professional		$964.87	$964.87	$1,490.25
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $798.40 / $798.40 / $1,274.84	Professional	TC	$798.40	$798.40	$1,274.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.63 / $261.80 / $318.26	Professional		$162.63	$261.80	$318.26
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.37 / $222.22 / $270.14	Professional	TC	$170.37	$222.22	$270.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $166.54 / $292.39	Professional		$28.64	$166.54	$292.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $202.49 / $385.36	Professional		$115.65	$202.49	$385.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $106.45 / $157.43 / $248.45	Professional	TC	$106.45	$157.43	$248.45
United Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $147.41 / $227.31	Professional		$108.27	$147.41	$227.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.66 / $113.68 / $180.64	Professional	TC	$80.66	$113.68	$180.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $170.81 / $232.38	Professional		$146.04	$170.81	$232.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $123.96 / $144.82 / $197.21	Professional	TC	$123.96	$144.82	$197.21