Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.84 / $199.50 / $497.62	Facility		$70.84	$199.50	$497.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $12.61 / $14.55	Facility	26	$7.78	$12.61	$14.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.75 / $223.67 / $497.62	Facility	TC	$28.75	$223.67	$497.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $37.86 / $90.25	Professional		$27.68	$37.86	$90.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.21 / $36.90	Professional	26	$7.78	$9.21	$36.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.00 / $180.51 / $298.00	Professional	50	$60.00	$180.51	$298.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.41 / $17.07 / $24.23	Professional	52	$15.41	$17.07	$24.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $27.69 / $54.79	Professional	TC	$24.44	$27.69	$54.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $46.46 / $59.74	Professional		$28.59	$46.46	$59.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $9.15 / $16.97	Professional	26	$6.65	$9.15	$16.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.34 / $79.18 / $88.46	Professional	50	$45.34	$79.18	$88.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $37.38 / $39.26	Professional	TC	$21.94	$37.38	$39.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.33 / $49.50 / $88.37	Professional		$28.33	$49.50	$88.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $13.97 / $22.44	Professional	26	$8.63	$13.97	$22.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $36.77 / $64.81	Professional	TC	$23.29	$36.77	$64.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.95 / $73.44 / $119.19	Facility		$58.95	$73.44	$119.19
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 $30.23 / $30.23 / $35.79	Facility	TC	$30.23	$30.23	$35.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.51 / $45.59 / $80.64	Professional		$31.51	$45.59	$80.64
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 $54.93 / $54.93 / $54.93	Professional	50	$54.93	$54.93	$54.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $33.90 / $63.98	Professional	TC	$23.08	$33.90	$63.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $86.50 / $359.91 / $359.91	Facility		$86.50	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $67.18 / $173.52 / $173.52	Facility	TC	$67.18	$173.52	$173.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.06 / $263.06 / $343.05	Professional		$263.06	$263.06	$343.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.26 / $79.26 / $79.26	Professional	26	$79.26	$79.26	$79.26
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.55 / $205.55 / $269.93	Professional	TC	$205.55	$205.55	$269.93
United Facility/Professional Professional Modifier Low / Median / High Price $31.90 / $41.69 / $74.63	Professional		$31.90	$41.69	$74.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $10.84 / $18.73	Professional	26	$9.10	$10.84	$18.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $31.38 / $54.04	Professional	TC	$23.08	$31.38	$54.04