Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.96 / $154.36 / $362.31	Facility	26	$102.96	$154.36	$362.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.44 / $425.00 / $800.00	Professional		$262.44	$425.00	$800.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.52 / $111.86 / $195.94	Professional	26	$71.52	$111.86	$195.94
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $122.86 / $158.80 / $237.03	Professional	52	$122.86	$158.80	$237.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.71 / $234.27 / $406.00	Professional	TC	$170.71	$234.27	$406.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.83 / $209.05 / $369.11	Professional		$140.83	$209.05	$369.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.80 / $71.23 / $130.63	Professional	26	$51.80	$71.23	$130.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $86.30 / $86.30 / $225.97	Professional	TC	$86.30	$86.30	$225.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.35 / $386.63 / $670.54	Professional		$173.35	$386.63	$670.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.50 / $110.30 / $177.22	Professional	26	$66.50	$110.30	$177.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.95 / $270.06 / $558.10	Professional	TC	$123.95	$270.06	$558.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.90 / $72.90 / $80.59	Facility	26	$72.90	$72.90	$80.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.32 / $412.45 / $763.77	Professional		$169.32	$412.45	$763.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.87 / $103.87 / $169.72	Professional	26	$59.87	$103.87	$169.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.64 / $266.60 / $662.03	Professional	TC	$106.64	$266.60	$662.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $641.91 / $641.91 / $659.84	Facility	26	$641.91	$641.91	$659.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,145.84 / $3,240.21 / $3,240.21	Professional		$3,145.84	$3,240.21	$3,240.21
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $577.89 / $577.89 / $577.89	Professional	26	$577.89	$577.89	$577.89
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,772.01 / $2,855.17 / $2,855.17	Professional	TC	$2,772.01	$2,855.17	$2,855.17
United Facility/Professional Professional Modifier Low / Median / High Price $203.20 / $350.47 / $583.90	Professional		$203.20	$350.47	$583.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $86.16 / $150.24	Professional	26	$70.06	$86.16	$150.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.13 / $220.35 / $465.38	Professional	TC	$133.13	$220.35	$465.38