Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.29 / $57.30 / $289.57	Facility	26	$57.29	$57.30	$289.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.56 / $310.26 / $618.00	Professional		$175.56	$310.26	$618.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $64.00 / $92.60	Professional	26	$55.00	$64.00	$92.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.26 / $223.11 / $375.94	Professional	TC	$120.26	$223.11	$375.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.42 / $121.39 / $121.39	Professional		$111.42	$121.39	$121.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.50 / $50.08 / $123.31	Professional	26	$44.50	$50.08	$123.31
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $265.58 / $265.58 / $265.58	Professional		$265.58	$265.58	$265.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.31 / $46.31 / $46.31	Facility	26	$46.31	$46.31	$46.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.21 / $346.71 / $621.66	Professional		$155.21	$346.71	$621.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.61 / $79.31 / $135.96	Professional	26	$43.61	$79.31	$135.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.29 / $251.34 / $502.19	Professional	TC	$107.29	$251.34	$502.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $218.13 / $289.30 / $931.42	Professional		$218.13	$289.30	$931.42
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 $150.44 / $180.91 / $245.42	Professional	TC	$150.44	$180.91	$245.42
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.31 / $199.19 / $425.49	Professional		$169.31	$199.19	$425.49
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.63 / $59.56 / $92.93	Professional	26	$50.63	$59.56	$92.93
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.69 / $139.63 / $246.35	Professional	TC	$118.69	$139.63	$246.35
United Facility/Professional Professional Modifier Low / Median / High Price $171.90 / $280.95 / $456.54	Professional		$171.90	$280.95	$456.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.02 / $72.56 / $122.16	Professional	26	$50.02	$72.56	$122.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.31 / $170.20 / $340.31	Professional	TC	$104.31	$170.20	$340.31