Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.59 / $1,394.70 / $1,708.25	Facility		$128.59	$1,394.70	$1,708.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.14 / $69.14 / $434.86	Facility	26	$69.14	$69.14	$434.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $149.80 / $252.15	Professional		$128.12	$149.80	$252.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.34 / $71.45 / $118.50	Professional	26	$51.34	$71.45	$118.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $62.65 / $67.25 / $102.75	Professional	52	$62.65	$67.25	$102.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.07 / $72.08 / $184.12	Professional	TC	$59.07	$72.08	$184.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $105.38 / $113.99	Professional		$105.38	$105.38	$113.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $63.75 / $95.27	Professional	26	$58.82	$63.75	$95.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.89 / $258.27 / $395.27	Professional		$126.89	$258.27	$395.27
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.02 / $88.90 / $191.84	Professional	26	$56.02	$88.90	$191.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.69 / $159.09 / $268.72	Professional	TC	$76.69	$159.09	$268.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.76 / $226.46 / $2,953.68	Facility		$167.76	$226.46	$2,953.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $99.39	Facility	26	$94.06	$94.06	$99.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $244.37 / $637.11	Professional		$129.31	$244.37	$637.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.83 / $96.41 / $172.57	Professional	26	$57.83	$96.41	$172.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.81 / $138.05 / $545.11	Professional	TC	$62.81	$138.05	$545.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $629.29 / $1,600.36 / $2,025.75	Facility		$629.29	$1,600.36	$2,025.75
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $188.75 / $386.03 / $386.03	Facility	26	$188.75	$386.03	$386.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,102.49 / $3,195.57 / $3,195.57	Professional		$3,102.49	$3,195.57	$3,195.57
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $551.37 / $551.37 / $667.80	Professional	26	$551.37	$551.37	$667.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,808.09 / $2,892.33 / $2,892.33	Professional	TC	$2,808.09	$2,892.33	$2,892.33
United Facility/Professional Professional Modifier Low / Median / High Price $153.16 / $233.93 / $500.02	Professional		$153.16	$233.93	$500.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.37 / $87.25 / $167.14	Professional	26	$59.37	$87.25	$167.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.37 / $126.04 / $395.85	Professional	TC	$72.37	$126.04	$395.85