Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.04 / $68.64 / $265.20	Facility	26	$53.04	$68.64	$265.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.87 / $272.27 / $472.00	Professional		$147.87	$272.27	$472.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $59.49 / $137.66	Professional	26	$51.30	$59.49	$137.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.92 / $194.37 / $301.27	Professional	TC	$96.92	$194.37	$301.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.27 / $92.27 / $92.27	Professional		$92.27	$92.27	$92.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.27 / $47.69 / $109.52	Professional	26	$39.27	$47.69	$109.52
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $94.85 / $94.85	Professional		$57.38	$94.85	$94.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.78 / $42.78 / $42.78	Facility	26	$42.78	$42.78	$42.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.69 / $284.99 / $513.16	Professional		$127.69	$284.99	$513.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.53 / $70.95 / $122.04	Professional	26	$38.53	$70.95	$122.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.63 / $201.53 / $410.52	Professional	TC	$84.63	$201.53	$410.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $180.20 / $238.83 / $762.13	Professional		$180.20	$238.83	$762.13
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 $119.75 / $143.94 / $195.46	Professional	TC	$119.75	$143.94	$195.46
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $163.09 / $341.02	Professional		$115.75	$163.09	$341.02
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $52.97 / $85.68	Professional	26	$45.02	$52.97	$85.68
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.60 / $110.12 / $231.27	Professional	TC	$93.60	$110.12	$231.27
United Facility/Professional Professional Modifier Low / Median / High Price $138.06 / $231.44 / $387.09	Professional		$138.06	$231.44	$387.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.14 / $65.48 / $109.71	Professional	26	$43.14	$65.48	$109.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.38 / $151.90 / $279.29	Professional	TC	$91.38	$151.90	$279.29