Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.85 / $64.20 / $229.41	Facility	26	$45.85	$64.20	$229.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.13 / $221.78 / $429.12	Professional		$141.13	$221.78	$429.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.86 / $55.00 / $99.31	Professional	26	$45.86	$55.00	$99.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.95 / $136.61 / $256.00	Professional	TC	$90.95	$136.61	$256.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.12 / $90.12 / $90.12	Professional		$90.12	$90.12	$90.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.54 / $43.86 / $109.52	Professional	26	$39.54	$43.86	$109.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.02 / $37.02 / $37.02	Facility	26	$37.02	$37.02	$37.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.05 / $267.13 / $497.72	Professional		$124.05	$267.13	$497.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $65.55 / $111.96	Professional	26	$38.01	$65.55	$111.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.13 / $184.96 / $367.44	Professional	TC	$81.13	$184.96	$367.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $175.87 / $233.05 / $665.41	Professional		$175.87	$233.05	$665.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.92 / $70.13 / $636.91	Professional	26	$59.92	$70.13	$636.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $115.42 / $138.74 / $636.91	Professional	TC	$115.42	$138.74	$636.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.30 / $159.18 / $290.23	Professional		$135.30	$159.18	$290.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $52.97 / $76.13	Professional	26	$45.02	$52.97	$76.13
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.29 / $106.22 / $168.94	Professional	TC	$90.29	$106.22	$168.94
United Facility/Professional Professional Modifier Low / Median / High Price $137.22 / $220.11 / $349.43	Professional		$137.22	$220.11	$349.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $65.48 / $106.45	Professional	26	$44.34	$65.48	$106.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.44 / $146.87 / $249.98	Professional	TC	$88.44	$146.87	$249.98