Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $13.89 / $57.96	Facility	26	$9.25	$13.89	$57.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.50 / $104.20 / $753.15	Facility	TC	$27.50	$104.20	$753.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.07 / $42.88 / $107.43	Professional		$35.07	$42.88	$107.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $10.75 / $34.29	Professional	26	$9.26	$10.75	$34.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.78 / $135.97 / $346.00	Professional	50	$18.78	$135.97	$346.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.54 / $19.39 / $27.57	Professional	52	$17.54	$19.39	$27.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.50 / $30.60 / $62.89	Professional	TC	$27.50	$30.60	$62.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $54.17 / $68.76	Professional		$32.11	$54.17	$68.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $10.93 / $18.70	Professional	26	$8.15	$10.93	$18.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.73 / $98.31 / $98.31	Professional	50	$52.73	$98.31	$98.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.89 / $45.05 / $45.05	Professional	TC	$42.89	$45.05	$45.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.03 / $56.86 / $97.20	Professional		$33.03	$56.86	$97.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.33 / $17.00 / $26.72	Professional	26	$10.33	$17.00	$26.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.20 / $40.65 / $75.23	Professional	TC	$25.20	$40.65	$75.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $13.25	Facility	26	$12.66	$12.66	$13.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.96 / $32.96 / $40.63	Facility	TC	$32.96	$32.96	$40.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.14 / $51.34 / $92.07	Professional		$36.14	$51.34	$92.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $15.77 / $25.05	Professional	26	$9.65	$15.77	$25.05
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.21 / $61.21 / $61.21	Professional	50	$61.21	$61.21	$61.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.01 / $37.59 / $69.75	Professional	TC	$25.01	$37.59	$69.75
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $100.00 / $100.00	Facility	26	$29.45	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $77.14 / $199.17 / $199.17	Facility	TC	$77.14	$199.17	$199.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $297.63 / $297.63 / $398.70	Professional		$297.63	$297.63	$398.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $87.52 / $89.18	Professional	26	$87.52	$87.52	$89.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.42 / $229.42 / $309.52	Professional	TC	$229.42	$229.42	$309.52
United Facility/Professional Professional Modifier Low / Median / High Price $36.59 / $47.39 / $84.97	Professional		$36.59	$47.39	$84.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $13.25 / $25.02	Professional	26	$10.76	$13.25	$25.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $34.52 / $61.66	Professional	TC	$25.71	$34.52	$61.66