Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $307.85 / $971.49 / $2,552.61	Facility		$307.85	$971.49	$2,552.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.72 / $117.12 / $650.40	Facility	26	$64.72	$117.12	$650.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.81 / $250.77 / $633.00	Professional		$182.81	$250.77	$633.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.44 / $75.79 / $242.00	Professional	26	$63.44	$75.79	$242.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.60 / $160.76 / $245.18	Professional	TC	$119.60	$160.76	$245.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.55 / $208.38 / $331.40	Professional		$144.55	$208.38	$331.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $94.50 / $121.53	Professional	26	$50.40	$94.50	$121.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.37 / $104.37 / $104.37	Professional	TC	$104.37	$104.37	$104.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.28 / $284.79 / $445.33	Professional		$198.28	$284.79	$445.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.63 / $91.97 / $138.72	Professional	26	$66.63	$91.97	$138.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.69 / $197.10 / $314.16	Professional	TC	$130.69	$197.10	$314.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $356.81 / $640.17	Facility		$219.59	$356.81	$640.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.04 / $293.91 / $470.08	Professional		$194.04	$293.91	$470.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $95.38 / $160.31	Professional	26	$66.81	$95.38	$160.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.09 / $197.05 / $325.14	Professional	TC	$122.09	$197.05	$325.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $397.09 / $1,026.33 / $1,026.33	Facility		$397.09	$1,026.33	$1,026.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $333.40 / $333.40	Facility	26	$160.72	$333.40	$333.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,949.29 / $3,949.29 / $3,949.29	Professional		$3,949.29	$3,949.29	$3,949.29
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $433.24 / $433.24 / $540.38	Professional	26	$433.24	$433.24	$540.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,005.74 / $1,033.30 / $1,075.65	Professional	TC	$1,005.74	$1,033.30	$1,075.65
United Facility/Professional Professional Modifier Low / Median / High Price $190.34 / $273.31 / $511.95	Professional		$190.34	$273.31	$511.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.31 / $85.66 / $152.03	Professional	26	$65.31	$85.66	$152.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.09 / $171.41 / $293.77	Professional	TC	$122.09	$171.41	$293.77