Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.86 / $445.50 / $992.55	Facility		$130.86	$445.50	$992.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.82 / $22.25 / $53.56	Facility	26	$19.82	$22.25	$53.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.66 / $145.69 / $276.63	Professional		$118.66	$145.69	$276.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $22.48 / $41.21	Professional	26	$19.82	$22.48	$41.21
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $58.77 / $65.43 / $92.28	Professional	52	$58.77	$65.43	$92.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.55 / $119.49 / $197.70	Professional	TC	$98.55	$119.49	$197.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $124.67 / $229.45	Professional		$113.34	$124.67	$229.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $21.12 / $38.19	Professional	26	$15.78	$21.12	$38.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.56 / $91.56 / $91.56	Professional	TC	$91.56	$91.56	$91.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.20 / $175.07 / $265.63	Professional		$110.20	$175.07	$265.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.09 / $27.92 / $42.75	Professional	26	$19.09	$27.92	$42.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.17 / $152.30 / $231.08	Professional	TC	$93.17	$152.30	$231.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.03 / $302.70 / $387.15	Facility		$159.03	$302.70	$387.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.72 / $24.72 / $24.72	Facility	26	$24.72	$24.72	$24.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.77 / $169.92 / $293.62	Professional		$119.77	$169.92	$293.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.84 / $27.68 / $47.22	Professional	26	$20.84	$27.68	$47.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.56 / $145.88 / $257.07	Professional	TC	$100.56	$145.88	$257.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $259.14 / $696.92 / $696.92	Facility		$259.14	$696.92	$696.92
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.94 / $176.87 / $176.87	Facility	26	$48.94	$176.87	$176.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,098.83 / $1,173.20 / $1,205.33	Professional		$1,098.83	$1,173.20	$1,205.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $310.41 / $310.41 / $310.41	Professional	26	$310.41	$310.41	$310.41
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $925.73 / $1,048.79 / $1,077.52	Professional	TC	$925.73	$1,048.79	$1,077.52
United Facility/Professional Professional Modifier Low / Median / High Price $121.48 / $158.76 / $264.61	Professional		$121.48	$158.76	$264.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $26.74 / $49.56	Professional	26	$20.47	$26.74	$49.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.01 / $139.86 / $232.82	Professional	TC	$101.01	$139.86	$232.82