Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.86 / $152.86 / $328.42	Facility	26	$92.86	$152.86	$328.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.88 / $425.00 / $922.86	Professional		$286.88	$425.00	$922.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.46 / $108.47 / $212.66	Professional	26	$82.46	$108.47	$212.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $131.50 / $131.50 / $131.50	Professional	50	$131.50	$131.50	$131.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.42 / $285.54 / $445.30	Professional	TC	$204.42	$285.54	$445.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.87 / $219.82 / $600.57	Professional		$159.87	$219.82	$600.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $73.65 / $146.65	Professional	26	$47.14	$73.65	$146.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.73 / $112.73 / $174.06	Professional	TC	$112.73	$112.73	$174.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.51 / $519.58 / $795.99	Professional		$239.51	$519.58	$795.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.72 / $97.80 / $156.68	Professional	26	$60.72	$97.80	$156.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $197.57 / $434.31 / $639.33	Professional	TC	$197.57	$434.31	$639.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.08 / $66.08 / $72.95	Facility	26	$66.08	$66.08	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $474.95 / $773.78	Professional		$203.72	$474.95	$773.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.20 / $94.09 / $153.51	Professional	26	$54.20	$94.09	$153.51
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $386.61 / $386.61 / $386.61	Professional	50	$386.61	$386.61	$386.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.33 / $357.34 / $661.65	Professional	TC	$155.33	$357.34	$661.65
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $583.84 / $583.84 / $596.96	Facility	26	$583.84	$583.84	$596.96
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 $531.65 / $531.65 / $531.65	Professional	26	$531.65	$531.65	$531.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,459.04 / $2,524.69 / $2,526.42	Professional	TC	$2,459.04	$2,524.69	$2,526.42
United Facility/Professional Professional Modifier Low / Median / High Price $238.60 / $427.00 / $631.46	Professional		$238.60	$427.00	$631.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $78.31 / $138.97	Professional	26	$64.09	$78.31	$138.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.30 / $320.37 / $496.57	Professional	TC	$177.30	$320.37	$496.57