Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.30 / $375.51 / $923.08	Facility		$95.30	$375.51	$923.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.32 / $31.86 / $62.23	Facility	26	$20.32	$31.86	$62.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $100.01 / $263.60 / $349.01	Facility	TC	$100.01	$263.60	$349.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.75 / $130.50 / $379.43	Professional		$58.75	$130.50	$379.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $24.70 / $90.29	Professional	26	$19.87	$24.70	$90.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.87 / $106.95 / $185.22	Professional	TC	$89.87	$106.95	$185.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $103.54 / $178.40	Professional		$81.81	$103.54	$178.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $21.05 / $39.17	Professional	26	$15.31	$21.05	$39.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.52 / $80.42 / $153.38	Professional	TC	$67.52	$80.42	$153.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.92 / $161.51 / $236.33	Professional		$99.92	$161.51	$236.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.92 / $27.85 / $42.15	Professional	26	$18.92	$27.85	$42.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.02 / $130.66 / $200.03	Professional	TC	$82.02	$130.66	$200.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.05 / $273.41 / $366.80	Facility		$141.05	$273.41	$366.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $23.98	Facility	26	$23.98	$23.98	$23.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $109.98	Facility	TC	$109.98	$109.98	$109.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.26 / $155.58 / $266.61	Professional		$111.26	$155.58	$266.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $27.76 / $46.76	Professional	26	$20.68	$27.76	$46.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.57 / $129.97 / $228.91	Professional	TC	$89.57	$129.97	$228.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $236.96 / $635.03 / $635.03	Facility		$236.96	$635.03	$635.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.87 / $106.00 / $107.00	Facility	26	$48.87	$106.00	$107.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $195.28 / $534.14 / $534.14	Facility	TC	$195.28	$534.14	$534.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $996.30 / $1,052.95 / $1,081.80	Professional		$996.30	$1,052.95	$1,081.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $237.75 / $237.75 / $237.75	Professional	26	$237.75	$237.75	$237.75
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $828.38 / $927.48 / $952.89	Professional	TC	$828.38	$927.48	$952.89
United Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $153.81 / $245.98	Professional		$111.74	$153.81	$245.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $27.06 / $47.56	Professional	26	$20.61	$27.06	$47.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.23 / $127.15 / $200.62	Professional	TC	$88.23	$127.15	$200.62