Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.96 / $209.12 / $486.86	Facility		$58.96	$209.12	$486.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $12.55 / $14.55	Facility	26	$7.78	$12.55	$14.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.03 / $212.34 / $491.58	Facility	TC	$23.03	$212.34	$491.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.16 / $32.52 / $76.27	Professional		$24.16	$32.52	$76.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.19 / $31.65	Professional	26	$7.78	$9.19	$31.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.48 / $111.31 / $192.00	Professional	50	$56.48	$111.31	$192.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $22.06 / $45.42	Professional	TC	$19.14	$22.06	$45.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $39.68 / $51.08	Professional		$23.58	$39.68	$51.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $9.65 / $16.97	Professional	26	$6.65	$9.65	$16.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.77 / $49.51 / $50.36	Professional	50	$38.77	$49.51	$50.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.10 / $27.59 / $33.29	Professional	TC	$15.10	$27.59	$33.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.84 / $42.02 / $74.89	Professional		$23.84	$42.02	$74.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $14.28 / $22.44	Professional	26	$8.63	$14.28	$22.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $28.16 / $51.93	Professional	TC	$17.39	$28.16	$51.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.53 / $63.78 / $96.75	Facility		$44.53	$63.78	$96.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $11.13	Facility	26	$10.36	$10.36	$11.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.44 / $22.44 / $29.08	Facility	TC	$22.44	$22.44	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $38.74 / $66.78	Professional		$26.95	$38.74	$66.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $12.87 / $20.81	Professional	26	$8.06	$12.87	$20.81
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.46 / $44.46 / $44.46	Professional	50	$44.46	$44.46	$44.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $26.85 / $49.32	Professional	TC	$19.10	$26.85	$49.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $73.69 / $359.91 / $359.91	Facility		$73.69	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $100.00 / $100.00	Facility	26	$27.00	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $54.35 / $140.51 / $140.51	Facility	TC	$54.35	$140.51	$140.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $221.82 / $221.82 / $292.13	Professional		$221.82	$221.82	$292.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.16 / $89.16 / $89.16	Professional	26	$89.16	$89.16	$89.16
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $177.00 / $219.00	Professional	TC	$177.00	$177.00	$219.00
United Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $36.10 / $63.22	Professional		$29.36	$36.10	$63.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $11.12 / $19.28	Professional	26	$9.10	$11.12	$19.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.78 / $25.48 / $44.69	Professional	TC	$19.78	$25.48	$44.69