Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.85 / $72.59 / $260.89	Facility	26	$51.85	$72.59	$260.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.32 / $223.22 / $413.00	Professional		$154.32	$223.22	$413.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.86 / $63.40 / $137.04	Professional	26	$51.86	$63.40	$137.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.16 / $154.94 / $265.69	Professional	TC	$98.16	$154.94	$265.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.50 / $120.81 / $139.38	Professional		$112.50	$120.81	$139.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.86 / $53.24 / $123.99	Professional	26	$44.86	$53.24	$123.99
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $105.89 / $188.97 / $600.00	Professional		$105.89	$188.97	$600.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $42.06 / $42.06	Facility	26	$42.06	$42.06	$42.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.37 / $297.00 / $520.57	Professional		$165.37	$297.00	$520.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.25 / $75.22 / $128.80	Professional	26	$43.25	$75.22	$128.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.58 / $215.62 / $390.33	Professional	TC	$118.58	$215.62	$390.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $249.30 / $720.22	Professional		$188.20	$249.30	$720.22
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.29 / $79.84 / $568.27	Professional	26	$68.29	$79.84	$568.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $119.35 / $143.47 / $568.27	Professional	TC	$119.35	$143.47	$568.27
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.59 / $170.36 / $346.97	Professional		$136.59	$170.36	$346.97
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.90 / $59.88 / $89.80	Professional	26	$50.90	$59.88	$89.80
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.91 / $110.48 / $244.19	Professional	TC	$93.91	$110.48	$244.19
United Facility/Professional Professional Modifier Low / Median / High Price $145.25 / $240.69 / $420.72	Professional		$145.25	$240.69	$420.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.34 / $71.86 / $114.35	Professional	26	$50.34	$71.86	$114.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.65 / $172.62 / $318.80	Professional	TC	$101.65	$172.62	$318.80