Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $141.25 / $416.87	Facility	26	$56.23	$141.25	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $302.00 / $645.65	Professional		$173.78	$302.00	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $218.78	Professional	26	$52.48	$87.10	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $213.80 / $489.78	Professional	TC	$123.03	$213.80	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $128.82 / $128.82	Professional		$120.23	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $50.12 / $89.13	Professional	26	$41.69	$50.12	$89.13
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $588.84	Professional		$186.21	$331.13	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $77.62 / $138.04	Professional	26	$39.81	$77.62	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $251.19 / $457.09	Professional	TC	$141.25	$251.19	$457.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $346.74	Professional		$213.80	$257.04	$346.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $97.72	Professional	26	$61.66	$70.79	$97.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $186.21 / $251.19	Professional	TC	$154.88	$186.21	$251.19
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $478.63	Professional		$194.98	$229.09	$478.63
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $53.70 / $107.15	Professional	26	$45.71	$53.70	$107.15
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $173.78 / $371.54	Professional	TC	$147.91	$173.78	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $489.78	Professional		$154.88	$275.42	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $64.57 / $114.82	Professional	26	$42.66	$64.57	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $204.17 / $389.05	Professional	TC	$114.82	$204.17	$389.05