Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.43 / $71.76 / $295.29	Facility	26	$58.43	$71.76	$295.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.13 / $324.02 / $618.00	Professional		$212.13	$324.02	$618.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.44 / $73.48 / $116.31	Professional	26	$58.44	$73.48	$116.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.19 / $229.82 / $364.97	Professional	TC	$140.19	$229.82	$364.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.78 / $167.20 / $225.10	Professional		$145.78	$167.20	$225.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.77 / $63.83 / $158.61	Professional	26	$56.77	$63.83	$158.61
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $83.11 / $83.11 / $275.82	Professional		$83.11	$83.11	$275.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.26 / $47.26 / $47.26	Facility	26	$47.26	$47.26	$47.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.87 / $377.51 / $655.04	Professional		$192.87	$377.51	$655.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.36 / $90.78 / $147.55	Professional	26	$54.36	$90.78	$147.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.15 / $296.69 / $507.94	Professional	TC	$142.15	$296.69	$507.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $261.51 / $346.41 / $917.67	Professional		$261.51	$346.41	$917.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.50 / $100.10 / $136.37	Professional	26	$85.50	$100.10	$136.37
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.24 / $210.76 / $285.76	Professional	TC	$175.24	$210.76	$285.76
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.26 / $239.13 / $421.91	Professional		$203.26	$239.13	$421.91
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.93 / $76.39 / $102.96	Professional	26	$64.93	$76.39	$102.96
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.31 / $162.72 / $377.99	Professional	TC	$138.31	$162.72	$377.99
United Facility/Professional Professional Modifier Low / Median / High Price $198.17 / $304.58 / $511.34	Professional		$198.17	$304.58	$511.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.64 / $87.82 / $145.88	Professional	26	$56.64	$87.82	$145.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.89 / $206.44 / $372.28	Professional	TC	$123.89	$206.44	$372.28