Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $418.83 / $2,133.00 / $7,602.00	Facility		$418.83	$2,133.00	$7,602.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.40 / $90.65 / $111.94	Facility	26	$38.40	$90.65	$111.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $235.68 / $546.00	Professional		$152.68	$235.68	$546.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $48.19 / $111.94	Professional	26	$39.95	$48.19	$111.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $156.77 / $257.05	Professional	TC	$98.17	$156.77	$257.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.41 / $197.41 / $197.41	Professional		$197.41	$197.41	$197.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $42.60 / $42.60	Professional	26	$42.60	$42.60	$42.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $150.00 / $1,676.00	Facility		$110.00	$150.00	$1,676.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.45 / $177.47 / $371.20	Professional		$111.45	$177.47	$371.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.14 / $51.32 / $86.11	Professional	26	$37.14	$51.32	$86.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.89 / $127.57 / $290.86	Professional	TC	$69.89	$127.57	$290.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.37 / $221.12 / $419.17	Professional		$149.37	$221.12	$419.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.29 / $58.86 / $109.09	Professional	26	$41.29	$58.86	$109.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.17 / $161.63 / $293.87	Professional	TC	$100.17	$161.63	$293.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,922.50 / $2,922.50	Facility		$55.00	$2,922.50	$2,922.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $101.27 / $181.86 / $190.52	Facility	26	$101.27	$181.86	$190.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,531.99 / $1,577.95 / $1,577.95	Professional		$1,531.99	$1,577.95	$1,577.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $684.00 / $907.84 / $907.84	Professional	26	$684.00	$907.84	$907.84
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,117.24 / $1,150.75 / $1,150.75	Professional	TC	$1,117.24	$1,150.75	$1,150.75
United Facility/Professional Facility Modifier Low / Median / High Price $294.00 / $808.00 / $2,577.00	Facility		$294.00	$808.00	$2,577.00
United Facility/Professional Professional Modifier Low / Median / High Price $143.34 / $233.09 / $421.37	Professional		$143.34	$233.09	$421.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.40 / $62.34 / $101.04	Professional	26	$39.40	$62.34	$101.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.57 / $144.49 / $271.18	Professional	TC	$85.57	$144.49	$271.18