Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $407.38 / $1,071.52	Facility		$151.36	$407.38	$1,071.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $53.70 / $58.88	Facility	26	$43.65	$53.70	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $407.38	Professional		$144.54	$181.97	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $51.29 / $114.82	Professional	26	$37.15	$51.29	$114.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $91.20 / $181.97 / $223.87	Professional	52	$91.20	$181.97	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $134.90 / $199.53	Professional	TC	$104.71	$134.90	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $117.49 / $154.88	Professional		$102.33	$117.49	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $38.02 / $57.54	Professional	26	$34.67	$38.02	$57.54
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $27.54 / $32.36 / $33.88	Professional	52	$27.54	$32.36	$33.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $87.10 / $102.33	Professional	TC	$81.28	$87.10	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $204.17 / $338.84	Professional		$114.82	$204.17	$338.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $70.79 / $100.00	Professional	26	$45.71	$70.79	$100.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $177.83 / $263.03	Professional	TC	$125.89	$177.83	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $309.03 / $1,584.89	Facility		$138.04	$309.03	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $363.08	Professional		$138.04	$223.87	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $66.07 / $102.33	Professional	26	$40.74	$66.07	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $158.49 / $251.19	Professional	TC	$97.72	$158.49	$251.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,380.38 / $2,187.76	Facility		$1,023.29	$1,380.38	$2,187.76
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $2,187.76 / $2,187.76	Professional		$1,023.29	$2,187.76	$2,187.76
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $309.03 / $309.03	Professional	26	$269.15	$309.03	$309.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $2,089.30 / $2,089.30	Professional	TC	$776.25	$2,089.30	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $338.84	Professional		$151.36	$213.80	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $61.66 / $95.50	Professional	26	$38.02	$61.66	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $151.36 / $239.88	Professional	TC	$109.65	$151.36	$239.88