Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.08 / $285.45 / $313.26	Facility		$37.08	$285.45	$313.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $20.56 / $52.90	Facility	26	$19.95	$20.56	$52.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $203.80 / $263.14 / $308.33	Facility	TC	$203.80	$263.14	$308.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.83 / $60.28 / $130.00	Professional		$33.83	$60.28	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $22.50 / $40.71	Professional	26	$19.32	$22.50	$40.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $281.35	Professional	50	$234.74	$234.74	$281.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.65 / $18.59 / $36.71	Professional	52	$15.65	$18.59	$36.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.38 / $21.92 / $62.77	Professional	TC	$15.38	$21.92	$62.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $39.39 / $58.41	Professional		$28.05	$39.39	$58.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.14 / $13.10 / $17.59	Professional	TC	$11.14	$13.10	$17.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $73.53 / $120.61	Professional		$37.13	$73.53	$120.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $29.04 / $42.97	Professional	26	$19.89	$29.04	$42.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $47.97 / $79.84	Professional	TC	$17.94	$47.97	$79.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $64.25 / $85.21	Facility		$41.38	$64.25	$85.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $28.92	Facility	26	$23.35	$23.35	$28.92
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $35.32	Facility	TC	$18.64	$18.64	$35.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $68.27 / $117.92	Professional		$35.97	$68.27	$117.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $26.64 / $47.22	Professional	26	$19.73	$26.64	$47.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.84 / $41.97 / $76.54	Professional	TC	$15.84	$41.97	$76.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $81.42 / $232.02 / $232.02	Facility		$81.42	$232.02	$232.02
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $101.79 / $101.79	Facility	26	$100.00	$101.79	$101.79
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $92.62 / $141.03 / $141.03	Facility	TC	$92.62	$141.03	$141.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $402.37 / $414.44 / $414.44	Professional		$402.37	$414.44	$414.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.60 / $130.60 / $163.95	Professional	26	$130.60	$130.60	$163.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $284.52 / $293.07 / $293.07	Professional	TC	$284.52	$293.07	$293.07
United Facility/Professional Professional Modifier Low / Median / High Price $42.32 / $59.49 / $108.42	Professional		$42.32	$59.49	$108.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $25.77 / $46.01	Professional	26	$19.80	$25.77	$46.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.44 / $33.97 / $78.51	Professional	TC	$21.44	$33.97	$78.51