Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.96 / $153.66 / $361.37	Facility	26	$102.96	$153.66	$361.37
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.63 / $70.98 / $137.69	Facility	53	$61.63	$70.98	$137.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.74 / $380.96 / $605.66	Professional		$251.74	$380.96	$605.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.92 / $111.36 / $203.00	Professional	26	$67.92	$111.36	$203.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.87 / $161.94 / $236.46	Professional	52	$125.87	$161.94	$236.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.84 / $225.45 / $369.35	Professional	TC	$176.84	$225.45	$369.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.82 / $292.50 / $429.10	Professional		$141.82	$292.50	$429.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.57 / $70.92 / $130.05	Professional	26	$51.57	$70.92	$130.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $90.24 / $90.24 / $230.00	Professional	TC	$90.24	$90.24	$230.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.85 / $406.96 / $745.80	Professional		$178.85	$406.96	$745.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.16 / $108.59 / $175.91	Professional	26	$66.16	$108.59	$175.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.22 / $277.50 / $619.57	Professional	TC	$128.22	$277.50	$619.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.70 / $72.70 / $80.26	Facility	26	$72.70	$72.70	$80.26
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.11 / $45.11 / $45.11	Facility	53	$45.11	$45.11	$45.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.23 / $422.46 / $755.90	Professional		$170.23	$422.46	$755.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.60 / $103.41 / $168.10	Professional	26	$59.60	$103.41	$168.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.30 / $277.02 / $646.78	Professional	TC	$112.30	$277.02	$646.78
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $638.88 / $638.88 / $656.72	Facility	26	$638.88	$638.88	$656.72
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $89.69 / $285.58 / $285.58	Facility	53	$89.69	$285.58	$285.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,872.81 / $2,958.99 / $2,958.99	Professional		$2,872.81	$2,958.99	$2,958.99
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $584.49 / $584.49 / $584.49	Professional	26	$584.49	$584.49	$584.49
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,498.98 / $2,573.94 / $2,573.94	Professional	TC	$2,498.98	$2,573.94	$2,573.94
United Facility/Professional Professional Modifier Low / Median / High Price $208.51 / $386.91 / $601.46	Professional		$208.51	$386.91	$601.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $87.23 / $151.97	Professional	26	$70.81	$87.23	$151.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.44 / $230.85 / $503.53	Professional	TC	$138.44	$230.85	$503.53