Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $181.97 / $1,621.81	Facility		$109.65	$181.97	$1,621.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $61.66 / $61.66	Facility	26	$46.77	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $102.33 / $426.58	Professional		$39.81	$102.33	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $48.98 / $151.36	Professional	26	$33.11	$48.98	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $169.82	Professional	TC	$25.12	$40.74	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.20 / $63.10	Professional		$21.38	$30.20	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	26	$39.81	$39.81	$39.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $16.60 / $22.91	Professional	TC	$15.14	$16.60	$22.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $229.09	Facility		$218.78	$218.78	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Facility	26	$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $194.98 / $398.11	Professional		$63.10	$194.98	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $81.28 / $151.36	Professional	26	$34.67	$81.28	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $100.00 / $257.04	Professional	TC	$28.18	$100.00	$257.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $112.20 / $134.90	Professional		$102.33	$112.20	$134.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $61.66 / $74.13	Professional	26	$56.23	$61.66	$74.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $51.29 / $60.26	Professional	TC	$45.71	$51.29	$60.26
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $478.63 / $676.08	Facility		$281.84	$478.63	$676.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $398.11	Professional		$52.48	$69.18	$398.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.02 / $154.88	Professional	26	$30.20	$38.02	$154.88
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $31.62 / $245.47	Professional	TC	$24.55	$31.62	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,884.03 / $7,762.47	Facility		$1,318.26	$2,884.03	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $89.13 / $229.09	Professional		$54.95	$89.13	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $48.98 / $95.50	Professional	26	$29.51	$48.98	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $38.02 / $128.82	Professional	TC	$23.44	$38.02	$128.82