Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.43 / $80.39 / $295.29	Facility	26	$58.43	$80.39	$295.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.10 / $335.16 / $590.63	Professional		$202.10	$335.16	$590.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $65.95 / $110.84	Professional	26	$55.00	$65.95	$110.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.63 / $239.33 / $387.85	Professional	TC	$145.63	$239.33	$387.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.68 / $235.68 / $235.68	Professional		$235.68	$235.68	$235.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.70 / $122.66 / $122.66	Professional	26	$47.70	$122.66	$122.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.51 / $47.51 / $47.51	Facility	26	$47.51	$47.51	$47.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.34 / $402.01 / $688.05	Professional		$209.34	$402.01	$688.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.61 / $81.12 / $141.90	Professional	26	$43.61	$81.12	$141.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.90 / $318.45 / $538.13	Professional	TC	$162.90	$318.45	$538.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $249.22 / $330.82 / $979.41	Professional		$249.22	$330.82	$979.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.14 / $78.45 / $107.13	Professional	26	$67.14	$78.45	$107.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.53 / $218.34 / $296.01	Professional	TC	$181.53	$218.34	$296.01
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.79 / $238.58 / $478.82	Professional		$202.79	$238.58	$478.82
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.32 / $59.20 / $104.46	Professional	26	$50.32	$59.20	$104.46
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.47 / $179.38 / $359.70	Professional	TC	$152.47	$179.38	$359.70
United Facility/Professional Professional Modifier Low / Median / High Price $202.93 / $310.30 / $545.32	Professional		$202.93	$310.30	$545.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.02 / $71.38 / $124.60	Professional	26	$50.02	$71.38	$124.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.19 / $235.60 / $425.69	Professional	TC	$139.19	$235.60	$425.69