Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $97.72 / $275.42	Facility	26	$54.95	$97.72	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $478.63	Professional		$131.83	$257.04	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $154.88	Professional	26	$43.65	$52.48	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $165.96 / $338.84	Professional	TC	$83.18	$165.96	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $229.09	Professional		$87.10	$117.49	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $83.18	Professional	26	$34.67	$45.71	$83.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $125.89	Professional	TC	$58.88	$89.13	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $389.05	Professional		$120.23	$190.55	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $79.43 / $125.89	Professional	26	$48.98	$79.43	$125.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $181.97 / $295.12	Professional	TC	$104.71	$181.97	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $263.03 / $426.58	Professional		$134.90	$263.03	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $69.18 / $123.03	Professional	26	$42.66	$69.18	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $190.55 / $316.23	Professional	TC	$87.10	$190.55	$316.23
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	26	$380.19	$380.19	$380.19
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional	TC	$1,348.96	$1,348.96	$1,348.96
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $239.88 / $354.81	Professional		$144.54	$239.88	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $60.26 / $100.00	Professional	26	$46.77	$60.26	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $162.18 / $239.88	Professional	TC	$95.50	$162.18	$239.88