Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.11 / $21.30 / $23.24	Facility	26	$21.11	$21.30	$23.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.64 / $133.94 / $216.72	Professional		$53.64	$133.94	$216.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $25.77 / $47.76	Professional	26	$21.30	$25.77	$47.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $214.40 / $214.40 / $214.40	Professional		$214.40	$214.40	$214.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.22 / $91.36 / $191.89	Professional		$38.22	$91.36	$191.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.02 / $158.02 / $158.02	Professional		$158.02	$158.02	$158.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $28.27 / $28.27	Professional	26	$28.27	$28.27	$28.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.51 / $158.69 / $159.16	Facility	26	$60.51	$158.69	$159.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,146.60 / $1,146.60 / $1,491.38	Professional		$1,146.60	$1,146.60	$1,491.38
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $196.77 / $196.77 / $256.88	Professional	26	$196.77	$196.77	$256.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $163.33 / $262.79 / $375.39	Professional		$163.33	$262.79	$375.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $50.70 / $62.73	Professional	26	$39.95	$50.70	$62.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.08 / $186.58 / $228.66	Professional		$42.08	$186.58	$228.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $158.02 / $158.02 / $158.02	Professional		$158.02	$158.02	$158.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $28.27 / $28.27	Professional	26	$28.27	$28.27	$28.27
United Facility/Professional Professional Modifier Low / Median / High Price $54.16 / $95.57 / $182.65	Professional		$54.16	$95.57	$182.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.07 / $34.58 / $55.83	Professional	26	$27.07	$34.58	$55.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $146.59 / $163.33 / $233.43	Professional		$146.59	$163.33	$233.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.23 / $30.06 / $41.77	Professional	26	$26.23	$30.06	$41.77