Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.32 / $425.00 / $629.00	Professional		$233.32	$425.00	$629.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.47 / $119.21 / $145.65	Professional	26	$64.47	$119.21	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.24 / $299.00 / $415.86	Professional	TC	$170.24	$299.00	$415.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.24 / $157.09 / $157.09	Professional		$136.24	$157.09	$157.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.88 / $48.89 / $130.09	Professional	26	$42.88	$48.89	$130.09
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $291.47 / $291.47 / $291.47	Professional		$291.47	$291.47	$291.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.19 / $44.19 / $44.19	Facility	26	$44.19	$44.19	$44.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.16 / $512.66 / $898.71	Professional		$207.16	$512.66	$898.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.32 / $78.23 / $133.41	Professional	26	$45.32	$78.23	$133.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.88 / $426.88 / $784.77	Professional	TC	$157.88	$426.88	$784.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $267.94 / $355.57 / $1,280.58	Professional		$267.94	$355.57	$1,280.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.20 / $83.33 / $113.60	Professional	26	$71.20	$83.33	$113.60
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.10 / $235.88 / $319.70	Professional	TC	$196.10	$235.88	$319.70
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.69 / $256.10 / $510.65	Professional		$217.69	$256.10	$510.65
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.44 / $62.87 / $99.99	Professional	26	$53.44	$62.87	$99.99
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $164.25 / $193.24 / $307.33	Professional	TC	$164.25	$193.24	$307.33
United Facility/Professional Professional Modifier Low / Median / High Price $200.17 / $370.86 / $631.27	Professional		$200.17	$370.86	$631.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.08 / $74.01 / $126.13	Professional	26	$53.08	$74.01	$126.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.12 / $256.97 / $492.86	Professional	TC	$151.12	$256.97	$492.86