Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $89.13 / $407.38	Facility	26	$56.23	$89.13	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $316.23 / $1,148.15	Professional		$186.21	$316.23	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $102.33 / $245.47	Professional	26	$60.26	$102.33	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $208.93 / $602.56	Professional	TC	$117.49	$208.93	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $177.83	Professional		$128.82	$162.18	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $123.03	Professional	26	$48.98	$60.26	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $128.82 / $154.88	Professional	TC	$112.20	$128.82	$154.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $147.91 / $602.56	Professional		$70.79	$147.91	$602.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $309.03 / $512.86	Professional		$162.18	$309.03	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $83.18 / $141.25	Professional	26	$47.86	$83.18	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $223.87 / $398.11	Professional	TC	$109.65	$223.87	$398.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $660.69	Professional		$218.78	$263.03	$660.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $660.69	Professional	26	$74.13	$87.10	$660.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $173.78 / $660.69	Professional	TC	$144.54	$173.78	$660.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $416.87	Professional		$173.78	$204.17	$416.87
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $66.07 / $109.65	Professional	26	$56.23	$66.07	$109.65
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $141.25 / $302.00	Professional	TC	$117.49	$141.25	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $257.04 / $436.52	Professional		$154.88	$257.04	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $128.82	Professional	26	$51.29	$74.13	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $181.97 / $309.03	Professional	TC	$102.33	$181.97	$309.03