Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.08 / $425.00 / $638.00	Professional		$272.08	$425.00	$638.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.18 / $119.21 / $140.00	Professional	26	$70.18	$119.21	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.21 / $299.00 / $433.05	Professional	TC	$199.21	$299.00	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.02 / $269.02 / $269.02	Professional		$269.02	$269.02	$269.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.88 / $65.88 / $65.88	Professional	26	$65.88	$65.88	$65.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $317.64 / $2,588.60	Professional		$108.00	$317.64	$2,588.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.77 / $48.77 / $48.77	Facility	26	$48.77	$48.77	$48.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.61 / $498.52 / $831.63	Professional		$240.61	$498.52	$831.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.63 / $87.92 / $147.31	Professional	26	$49.63	$87.92	$147.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.16 / $398.48 / $680.33	Professional	TC	$181.16	$398.48	$680.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $311.06 / $413.24 / $1,217.35	Professional		$311.06	$413.24	$1,217.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.06 / $91.24 / $124.58	Professional	26	$78.06	$91.24	$124.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $232.35 / $279.41 / $379.01	Professional	TC	$232.35	$279.41	$379.01
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.09 / $298.93 / $519.64	Professional		$254.09	$298.93	$519.64
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.02 / $69.44 / $97.04	Professional	26	$59.02	$69.44	$97.04
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.07 / $229.49 / $364.99	Professional	TC	$195.07	$229.49	$364.99
United Facility/Professional Professional Modifier Low / Median / High Price $252.58 / $412.69 / $675.58	Professional		$252.58	$412.69	$675.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.09 / $72.36 / $129.91	Professional	26	$51.09	$72.36	$129.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.01 / $318.67 / $536.29	Professional	TC	$179.01	$318.67	$536.29