Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $302.00 / $549.54	Facility	26	$147.91	$302.00	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $524.81 / $1,174.90	Professional		$213.80	$524.81	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $177.83 / $436.52	Professional	26	$100.00	$177.83	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $446.68 / $870.96	Professional	TC	$281.84	$446.68	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $831.76	Professional		$251.19	$380.19	$831.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $97.72 / $234.42	Professional	26	$75.86	$97.72	$234.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $354.81 / $416.87	Professional	TC	$204.17	$354.81	$416.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $1,047.13	Professional		$338.84	$501.19	$1,047.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $162.18 / $257.04	Professional	26	$100.00	$162.18	$257.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $575.44 / $933.25	Professional	TC	$323.59	$575.44	$933.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $724.44 / $1,288.25	Professional		$371.54	$724.44	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $141.25 / $245.47	Professional	26	$89.13	$141.25	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $549.54 / $1,096.48	Professional	TC	$281.84	$549.54	$1,096.48
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	26	$933.25	$933.25	$933.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	26	$891.25	$891.25	$891.25
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Professional	TC	$5,623.41	$5,623.41	$5,623.41
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $691.83 / $1,122.02	Professional		$416.87	$691.83	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $120.23 / $213.80	Professional	26	$97.72	$120.23	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $501.19 / $891.25	Professional	TC	$316.23	$501.19	$891.25