Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.88 / $68.64 / $282.45	Facility	26	$55.88	$68.64	$282.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.96 / $302.93 / $531.45	Professional		$171.96	$302.93	$531.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.05 / $63.16 / $110.47	Professional	26	$51.05	$63.16	$110.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.07 / $234.30 / $372.60	Professional	TC	$122.07	$234.30	$372.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $109.00 / $175.05	Professional		$109.00	$109.00	$175.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $50.59 / $109.52	Professional	26	$40.94	$50.59	$109.52
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $98.00 / $98.00	Professional		$98.00	$98.00	$98.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.13 / $45.13 / $45.13	Facility	26	$45.13	$45.13	$45.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.35 / $346.35 / $608.82	Professional		$189.35	$346.35	$608.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.53 / $75.67 / $136.35	Professional	26	$38.53	$75.67	$136.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.91 / $267.94 / $478.62	Professional	TC	$144.91	$267.94	$478.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $214.04 / $284.02 / $841.79	Professional		$214.04	$284.02	$841.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.92 / $70.13 / $95.58	Professional	26	$59.92	$70.13	$95.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.59 / $184.70 / $250.54	Professional	TC	$153.59	$184.70	$250.54
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.66 / $219.60 / $402.53	Professional		$186.66	$219.60	$402.53
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $52.97 / $81.66	Professional	26	$45.02	$52.97	$81.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.63 / $166.64 / $294.01	Professional	TC	$141.63	$166.64	$294.01
United Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $272.39 / $472.28	Professional		$150.97	$272.39	$472.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.40 / $65.48 / $111.70	Professional	26	$42.40	$65.48	$111.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.19 / $209.87 / $382.33	Professional	TC	$128.19	$209.87	$382.33