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 / $302.00	Facility	26	$54.95	$97.72	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $263.03 / $446.68	Professional		$128.82	$263.03	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $158.49	Professional	26	$51.29	$77.62	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $323.59	Professional	TC	$141.25	$218.78	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $371.54	Professional		$173.78	$173.78	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $128.82	Professional	26	$40.74	$56.23	$128.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $489.78	Professional		$158.49	$245.47	$489.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $138.04	Professional	26	$54.95	$87.10	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $269.15 / $407.38	Professional	TC	$147.91	$269.15	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Facility	26	$57.54	$57.54	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $512.86	Professional		$186.21	$302.00	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $77.62 / $131.83	Professional	26	$47.86	$77.62	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $234.42 / $389.05	Professional	TC	$134.90	$234.42	$389.05
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	26	$501.19	$501.19	$501.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,698.24 / $1,698.24	Professional		$1,659.59	$1,698.24	$1,698.24
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $346.74 / $436.52 / $436.52	Professional	26	$346.74	$436.52	$436.52
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,348.96 / $1,380.38	Professional	TC	$1,348.96	$1,348.96	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $436.52	Professional		$204.17	$275.42	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $114.82	Professional	26	$53.70	$64.57	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $331.13	Professional	TC	$147.91	$213.80	$331.13