Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.17 / $73.05 / $260.89	Facility	26	$52.17	$73.05	$260.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.29 / $223.39 / $401.00	Professional		$146.29	$223.39	$401.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $63.40 / $126.48	Professional	26	$52.18	$63.40	$126.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.52 / $139.16 / $255.31	Professional	TC	$89.52	$139.16	$255.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $104.75 / $117.47	Professional		$91.28	$104.75	$117.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $50.88 / $124.66	Professional	26	$44.68	$50.88	$124.66
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $108.43 / $296.82	Professional		$96.00	$108.43	$296.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $42.06 / $42.06	Facility	26	$42.06	$42.06	$42.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $264.42 / $473.00	Professional		$132.19	$264.42	$473.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.25 / $75.67 / $128.80	Professional	26	$43.25	$75.67	$128.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.98 / $192.00 / $331.10	Professional	TC	$87.98	$192.00	$331.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $177.52 / $234.80 / $631.66	Professional		$177.52	$234.80	$631.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.29 / $79.84 / $567.15	Professional	26	$68.29	$79.84	$567.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $108.67 / $130.74 / $567.15	Professional	TC	$108.67	$130.74	$567.15
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $160.06 / $266.42	Professional		$108.99	$160.06	$266.42
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.21 / $60.25 / $88.75	Professional	26	$51.21	$60.25	$88.75
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.85 / $99.82 / $231.84	Professional	TC	$84.85	$99.82	$231.84
United Facility/Professional Professional Modifier Low / Median / High Price $123.99 / $210.32 / $343.63	Professional		$123.99	$210.32	$343.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $72.25 / $119.63	Professional	26	$48.28	$72.25	$119.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.12 / $137.68 / $233.87	Professional	TC	$78.12	$137.68	$233.87