Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.48 / $177.71 / $314.30	Facility	26	$118.48	$177.71	$314.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $580.34 / $777.53 / $1,192.58	Professional		$580.34	$777.53	$1,192.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.29 / $137.47 / $353.27	Professional	26	$114.29	$137.47	$353.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $277.01 / $321.61 / $574.72	Professional	52	$277.01	$321.61	$574.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $461.85 / $607.95 / $942.56	Professional	TC	$461.85	$607.95	$942.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $534.33 / $554.66 / $809.92	Professional		$534.33	$554.66	$809.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $111.94 / $151.90 / $222.34	Professional	26	$111.94	$151.90	$222.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $573.83 / $846.01 / $1,233.21	Professional		$573.83	$846.01	$1,233.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.16 / $171.12 / $253.43	Professional	26	$117.16	$171.12	$253.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $456.67 / $674.97 / $981.44	Professional	TC	$456.67	$674.97	$981.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $636.49 / $883.38 / $1,601.85	Professional		$636.49	$883.38	$1,601.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.28 / $186.14 / $317.68	Professional	26	$127.28	$186.14	$317.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $500.00 / $682.18 / $1,226.94	Professional	TC	$500.00	$682.18	$1,226.94
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $286.83 / $753.90 / $753.90	Facility	26	$286.83	$753.90	$753.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,200.00 / $6,200.00 / $6,200.00	Professional		$6,200.00	$6,200.00	$6,200.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,081.48 / $1,081.48 / $1,081.48	Professional	26	$1,081.48	$1,081.48	$1,081.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $3,875.48 / $3,991.74 / $4,567.58	Professional	TC	$3,875.48	$3,991.74	$4,567.58
United Facility/Professional Professional Modifier Low / Median / High Price $584.00 / $836.04 / $1,384.25	Professional		$584.00	$836.04	$1,384.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.28 / $165.82 / $288.26	Professional	26	$116.28	$165.82	$288.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $464.62 / $669.05 / $1,080.24	Professional	TC	$464.62	$669.05	$1,080.24