Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $416.87 / $758.58	Facility	26	$147.91	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $1,698.24	Professional		$275.42	$467.74	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $288.40	Professional	26	$70.79	$120.23	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $645.65	Professional	TC	$204.17	$316.23	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $208.93	Professional		$173.78	$181.97	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $64.57	Professional	26	$64.57	$64.57	$64.57
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $316.23 / $2,570.40	Professional		$107.15	$316.23	$2,570.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $758.58	Professional		$234.42	$478.63	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $91.20 / $154.88	Professional	26	$51.29	$91.20	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $371.54 / $645.65	Professional	TC	$181.97	$371.54	$645.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $371.54 / $501.19	Professional		$309.03	$371.54	$501.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $123.03	Professional	26	$77.62	$91.20	$123.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $281.84 / $380.19	Professional	TC	$234.42	$281.84	$380.19
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $309.03 / $588.84	Professional		$263.03	$309.03	$588.84
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $117.49	Professional	26	$60.26	$70.79	$117.49
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $239.88 / $467.74	Professional	TC	$204.17	$239.88	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $407.38 / $707.95	Professional		$229.09	$407.38	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $144.54	Professional	26	$53.70	$75.86	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $309.03 / $575.44	Professional	TC	$173.78	$309.03	$575.44