Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.86 / $142.19 / $331.65	Facility	26	$92.86	$142.19	$331.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.58 / $425.00 / $725.00	Professional		$259.58	$425.00	$725.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.31 / $103.70 / $192.70	Professional	26	$74.31	$103.70	$192.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,218.00 / $1,218.00 / $1,218.00	Professional	50	$1,218.00	$1,218.00	$1,218.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $167.56 / $244.57	Professional	52	$125.00	$167.56	$244.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $259.35 / $435.28	Professional	TC	$187.50	$259.35	$435.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.57 / $238.17 / $442.73	Professional		$146.57	$238.17	$442.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.37 / $65.13 / $147.35	Professional	26	$47.37	$65.13	$147.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.19 / $99.19 / $253.00	Professional	TC	$99.19	$99.19	$253.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.70 / $377.59 / $703.42	Professional		$178.70	$377.59	$703.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.33 / $100.66 / $162.27	Professional	26	$61.33	$100.66	$162.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.44 / $281.07 / $587.50	Professional	TC	$138.44	$281.07	$587.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.73 / $66.73 / $73.64	Facility	26	$66.73	$66.73	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.69 / $426.69 / $725.00	Professional		$179.69	$426.69	$725.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.10 / $95.27 / $155.88	Professional	26	$55.10	$95.27	$155.88
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $343.71 / $343.71 / $343.71	Professional	50	$343.71	$343.71	$343.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.61 / $300.52 / $607.07	Professional	TC	$121.61	$300.52	$607.07
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $586.88 / $586.88 / $603.28	Facility	26	$586.88	$586.88	$603.28
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,789.74 / $2,873.43 / $2,873.43	Professional		$2,789.74	$2,873.43	$2,873.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $542.85 / $542.85 / $542.85	Professional	26	$542.85	$542.85	$542.85
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,451.15 / $2,524.69 / $2,524.69	Professional	TC	$2,451.15	$2,524.69	$2,524.69
United Facility/Professional Professional Modifier Low / Median / High Price $213.07 / $343.04 / $580.51	Professional		$213.07	$343.04	$580.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.45 / $80.42 / $140.74	Professional	26	$65.45	$80.42	$140.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.82 / $245.43 / $449.22	Professional	TC	$146.82	$245.43	$449.22