Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.76 / $133.01 / $399.02	Facility		$99.76	$133.01	$399.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.76 / $64.98 / $186.90	Professional		$49.76	$64.98	$186.90
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $215.59 / $215.59 / $215.59	Professional	22	$215.59	$215.59	$215.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.70 / $70.58 / $763.19	Professional	26	$27.70	$70.58	$763.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.88 / $26.31 / $33.64	Professional	52	$24.88	$26.31	$33.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.54 / $30.47 / $92.87	Professional	TC	$22.54	$30.47	$92.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $35.14 / $109.88	Professional		$32.29	$35.14	$109.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $17.17 / $68.02	Professional	26	$16.86	$17.17	$68.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.45 / $17.42 / $21.37	Professional	TC	$15.45	$17.42	$21.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.72 / $113.01 / $155.68	Professional		$57.72	$113.01	$155.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.54 / $48.56 / $69.88	Professional	26	$32.54	$48.56	$69.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.14 / $48.54 / $94.23	Professional	TC	$26.14	$48.54	$94.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.61 / $50.87 / $146.00	Facility		$47.61	$50.87	$146.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.57 / $18.77 / $78.29	Facility	26	$17.57	$18.77	$78.29
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.06 / $32.11 / $67.70	Facility	TC	$30.06	$32.11	$67.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.18 / $66.61 / $185.57	Professional		$33.18	$66.61	$185.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.35 / $31.72 / $76.63	Professional	26	$17.35	$31.72	$76.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.34 / $24.16 / $70.43	Professional	TC	$14.34	$24.16	$70.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $369.57 / $375.35	Facility		$135.00	$369.57	$375.35
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.99 / $163.47 / $179.84	Facility	26	$85.99	$163.47	$179.84
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $68.31 / $216.27 / $216.27	Facility	TC	$68.31	$216.27	$216.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $547.54 / $563.97 / $592.20	Professional		$547.54	$563.97	$592.20
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $292.24 / $292.24 / $292.24	Professional	26	$292.24	$292.24	$292.24
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $349.50 / $352.47 / $359.07	Professional	TC	$349.50	$352.47	$359.07
United Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $66.61 / $157.21	Professional		$39.31	$66.61	$157.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.28 / $35.47 / $70.47	Professional	26	$21.28	$35.47	$70.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $32.11 / $70.43	Professional	TC	$17.21	$32.11	$70.43