Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $512.86 / $1,000.00	Facility		$218.78	$512.86	$1,000.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $39.81 / $53.70	Facility	26	$35.48	$39.81	$53.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $194.98 / $263.03 / $1,047.13	Facility	TC	$194.98	$263.03	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $588.84	Professional		$199.53	$281.84	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $102.33	Professional	26	$33.88	$45.71	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $436.52	Professional	TC	$173.78	$229.09	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $186.21 / $354.81	Professional		$151.36	$186.21	$354.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $70.79	Professional	26	$28.18	$37.15	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $173.78 / $234.42	Professional	TC	$141.25	$173.78	$234.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $501.19	Professional		$186.21	$288.40	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $50.12 / $81.28	Professional	26	$34.67	$50.12	$81.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $295.12 / $446.68	Professional	TC	$194.98	$295.12	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $537.03 / $812.83	Facility		$194.98	$537.03	$812.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $42.66 / $60.26	Facility	26	$9.12	$42.66	$60.26
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $218.78 / $309.03	Facility	TC	$46.77	$218.78	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $478.63	Professional		$213.80	$295.12	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.65 / $72.44	Professional	26	$32.36	$43.65	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $257.04 / $426.58	Professional	TC	$181.97	$257.04	$426.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility	TC	$1,348.96	$1,348.96	$1,348.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	26	$398.11	$398.11	$398.11
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,698.24 / $1,698.24 / $1,819.70	Professional	TC	$1,698.24	$1,698.24	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $478.63	Professional		$218.78	$288.40	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $72.44	Professional	26	$30.90	$39.81	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $398.11	Professional	TC	$190.55	$245.47	$398.11