Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.20 / $17.66 / $77.33	Facility	26	$12.20	$17.66	$77.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $44.53 / $85.98 / $271.13	Facility	TC	$44.53	$85.98	$271.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $47.17 / $96.98	Professional		$42.95	$47.17	$96.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $13.68 / $27.80	Professional	26	$12.19	$13.68	$27.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.00 / $75.00 / $75.00	Professional	50	$75.00	$75.00	$75.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.75 / $33.14 / $59.05	Professional	TC	$30.75	$33.14	$59.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $52.47 / $62.01	Professional		$38.15	$52.47	$62.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $14.33 / $32.35	Professional	26	$10.43	$14.33	$32.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $52.23 / $52.23	Professional	TC	$25.05	$52.23	$52.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.02 / $68.40 / $115.03	Professional		$39.02	$68.40	$115.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.21 / $21.99 / $35.61	Professional	26	$13.21	$21.99	$35.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.94 / $46.69 / $82.34	Professional	TC	$29.94	$46.69	$82.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $17.67	Facility	26	$16.14	$16.14	$17.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $38.02 / $44.74	Facility	TC	$38.02	$38.02	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.94 / $63.94 / $111.36	Professional		$42.94	$63.94	$111.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $20.27 / $33.04	Professional	26	$12.42	$20.27	$33.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.17 / $44.79 / $76.06	Professional	TC	$30.17	$44.79	$76.06
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $84.96 / $219.36 / $219.36	Facility	TC	$84.96	$219.36	$219.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $345.18 / $345.18 / $453.53	Professional		$345.18	$345.18	$453.53
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.67 / $89.67 / $112.88	Professional	26	$89.67	$89.67	$112.88
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $255.46 / $255.46 / $340.65	Professional	TC	$255.46	$255.46	$340.65
United Facility/Professional Professional Modifier Low / Median / High Price $45.84 / $57.67 / $98.59	Professional		$45.84	$57.67	$98.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.09 / $17.44 / $31.98	Professional	26	$14.09	$17.44	$31.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.55 / $40.22 / $70.59	Professional	TC	$31.55	$40.22	$70.59