Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.68 / $48.56 / $105.85	Facility	26	$34.68	$48.56	$105.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.30 / $171.00 / $401.00	Professional		$103.30	$171.00	$401.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.69 / $41.95 / $90.71	Professional	26	$34.69	$41.95	$90.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.19 / $118.51 / $227.00	Professional	TC	$64.19	$118.51	$227.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $81.06 / $108.48	Professional		$50.42	$81.06	$108.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.63 / $35.99 / $74.09	Professional	26	$29.63	$35.99	$74.09
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $97.20 / $600.00	Professional		$42.84	$97.20	$600.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $46.57 / $78.45 / $691.00	Professional	26	$46.57	$78.45	$691.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.97 / $27.97 / $27.97	Facility	26	$27.97	$27.97	$27.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $200.80 / $389.73	Professional		$89.03	$200.80	$389.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.45 / $50.54 / $84.85	Professional	26	$28.45	$50.54	$84.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.04 / $139.81 / $307.94	Professional	TC	$56.04	$139.81	$307.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $126.37 / $167.34 / $523.36	Professional		$126.37	$167.34	$523.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $52.93 / $522.14	Professional	26	$45.28	$52.93	$522.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.73 / $97.09 / $522.14	Professional	TC	$80.73	$97.09	$522.14
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.58 / $112.45 / $266.91	Professional		$95.58	$112.45	$266.91
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.99 / $39.99 / $58.50	Professional	26	$33.99	$39.99	$58.50
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.57 / $72.44 / $200.42	Professional	TC	$61.57	$72.44	$200.42
United Facility/Professional Professional Modifier Low / Median / High Price $89.07 / $155.10 / $250.02	Professional		$89.07	$155.10	$250.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.47 / $48.04 / $76.62	Professional	26	$33.47	$48.04	$76.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.20 / $100.19 / $182.33	Professional	TC	$61.20	$100.19	$182.33