Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $295.12 / $676.08	Facility		$81.28	$295.12	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $33.11 / $151.36	Facility	26	$23.99	$33.11	$151.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $83.18 / $316.23	Facility	TC	$48.98	$83.18	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $354.81	Professional		$72.44	$117.49	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $109.65	Professional	26	$23.99	$40.74	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $70.79 / $162.18	Professional	TC	$48.98	$70.79	$162.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $141.25	Professional		$58.88	$75.86	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $52.48	Professional	26	$20.42	$27.54	$52.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $52.48 / $87.10	Professional	TC	$40.74	$52.48	$87.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $186.21	Professional		$70.79	$104.71	$186.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $41.69 / $66.07	Professional	26	$26.92	$41.69	$66.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $91.20 / $134.90	Professional	TC	$54.95	$91.20	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $162.18 / $257.04	Facility		$107.15	$162.18	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $45.71	Facility	26	$6.76	$31.62	$45.71
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	TC	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $186.21	Professional		$75.86	$102.33	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $60.26	Professional	26	$24.55	$36.31	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $72.44 / $128.82	Professional	TC	$50.12	$72.44	$128.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	TC	$389.05	$389.05	$389.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $724.44 / $724.44	Professional		$562.34	$724.44	$724.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	26	$229.09	$229.09	$229.09
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $501.19 / $501.19	Professional	TC	$389.05	$501.19	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $109.65 / $134.90	Facility		$77.62	$109.65	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $169.82	Professional		$81.28	$102.33	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $33.11 / $54.95	Professional	26	$26.30	$33.11	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $67.61 / $114.82	Professional	TC	$54.95	$67.61	$114.82