Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $131.83 / $263.03	Facility	26	$117.49	$131.83	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,412.54	Professional		$575.44	$758.58	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $158.49 / $380.19	Professional	26	$114.82	$158.49	$380.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $218.78 / $616.60	Professional	52	$181.97	$218.78	$616.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $588.84 / $1,071.52	Professional	TC	$467.74	$588.84	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $616.60 / $812.83	Professional		$537.03	$616.60	$812.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $138.04 / $177.83	Professional	26	$109.65	$138.04	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $524.81 / $602.56	Professional	TC	$467.74	$524.81	$602.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $741.31 / $1,258.93	Professional		$467.74	$741.31	$1,258.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $190.55 / $281.84	Professional	26	$131.83	$190.55	$281.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $724.44 / $1,096.48	Professional	TC	$512.86	$724.44	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,479.11	Professional		$602.56	$870.96	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $186.21 / $309.03	Professional	26	$123.03	$186.21	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $676.08 / $1,174.90	Professional	TC	$478.63	$676.08	$1,174.90
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional	26	$1,071.52	$1,071.52	$1,071.52
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $3,981.07 / $4,570.88 / $4,570.88	Professional	TC	$3,981.07	$4,570.88	$4,570.88
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $1,230.27	Professional		$588.84	$812.83	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $173.78 / $269.15	Professional	26	$117.49	$173.78	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $645.65 / $1,023.29	Professional	TC	$467.74	$645.65	$1,023.29