Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $134.90	Professional		$77.62	$107.15	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $60.26	Professional	26	$33.88	$50.12	$60.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $64.57 / $75.86	Professional	TC	$64.57	$64.57	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,000.00 / $1,000.00	Professional		$309.03	$1,000.00	$1,000.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $371.54 / $371.54	Professional	26	$281.84	$371.54	$371.54
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $794.33 / $794.33	Professional	TC	$794.33	$794.33	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $95.50	Professional		$32.36	$33.11	$95.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $239.88	Professional		$177.83	$208.93	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $245.47	Professional		$107.15	$147.91	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.67 / $79.43	Professional	26	$34.67	$44.67	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $102.33 / $169.82	Professional	TC	$67.61	$102.33	$169.82