Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $134.90 / $302.00	Facility		$67.61	$134.90	$302.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $9.55 / $43.65	Facility	26	$6.92	$9.55	$43.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $30.90 / $229.09	Facility	TC	$20.42	$30.90	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $32.36 / $95.50	Professional		$7.94	$32.36	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $12.88 / $39.81	Professional	26	$6.92	$12.88	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $70.79 / $190.55	Professional	50	$17.78	$70.79	$190.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $33.11 / $33.11	Professional	52	$33.11	$33.11	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.88 / $74.13	Professional	TC	$19.95	$33.88	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.84 / $45.71	Professional		$21.38	$28.84	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.59 / $13.80	Professional	26	$5.89	$7.59	$13.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $47.86 / $72.44	Professional	50	$34.67	$47.86	$72.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $23.99 / $36.31	Professional	TC	$16.22	$23.99	$36.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $32.36 / $67.61	Professional		$19.50	$32.36	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $20.89	Professional	26	$7.94	$13.18	$20.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $58.88	Professional	TC	$20.89	$32.36	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $58.88 / $97.72	Facility		$44.67	$58.88	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $9.77 / $9.77	Facility	26	$9.77	$9.77	$9.77
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	TC	$25.70	$25.70	$25.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $66.07	Professional		$26.30	$36.31	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.22 / $19.05	Professional	26	$7.24	$11.22	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $51.29	Professional	TC	$18.62	$26.92	$51.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $363.08	Facility		$218.78	$218.78	$363.08
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	TC	$169.82	$169.82	$169.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $288.40	Professional		$218.78	$288.40	$288.40
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	26	$67.61	$67.61	$67.61
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $223.87 / $223.87	Professional	TC	$169.82	$223.87	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $81.28 / $95.50	Facility		$35.48	$81.28	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $61.66	Professional		$28.18	$33.88	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.55 / $16.60	Professional	26	$7.94	$9.55	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $24.55 / $45.71	Professional	TC	$19.50	$24.55	$45.71