Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $136.15 / $518.49	Facility	26	$119.20	$136.15	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.74 / $475.00 / $1,116.22	Professional		$349.74	$475.00	$1,116.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.64 / $140.00 / $243.60	Professional	26	$101.64	$140.00	$243.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.80 / $335.00 / $541.22	Professional	TC	$243.80	$335.00	$541.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $236.06 / $303.77 / $346.65	Professional		$236.06	$303.77	$346.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.00 / $83.94 / $125.11	Professional	26	$75.00	$83.94	$125.11
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $108.38 / $500.76 / $1,100.00	Professional		$108.38	$500.76	$1,100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $70.73 / $70.73	Facility	26	$70.73	$70.73	$70.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.06 / $766.21 / $1,456.16	Professional		$327.06	$766.21	$1,456.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.95 / $126.90 / $212.72	Professional	26	$71.95	$126.90	$212.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $246.24 / $592.32 / $1,261.08	Professional	TC	$246.24	$592.32	$1,261.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $402.01 / $533.80 / $2,199.78	Professional		$402.01	$533.80	$2,199.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.01 / $133.99 / $2,439.65	Professional	26	$115.01	$133.99	$2,439.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $286.26 / $344.34 / $2,439.65	Professional	TC	$286.26	$344.34	$2,439.65
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.73 / $382.03 / $752.09	Professional		$324.73	$382.03	$752.09
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.25 / $100.29 / $150.41	Professional	26	$85.25	$100.29	$150.41
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.48 / $281.74 / $497.09	Professional	TC	$239.48	$281.74	$497.09
United Facility/Professional Professional Modifier Low / Median / High Price $306.45 / $528.28 / $998.57	Professional		$306.45	$528.28	$998.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.84 / $115.29 / $199.68	Professional	26	$85.84	$115.29	$199.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.88 / $374.68 / $816.78	Professional	TC	$217.88	$374.68	$816.78