Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $416.87 / $758.58	Facility	26	$147.91	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $537.03 / $1,819.70	Professional		$338.84	$537.03	$1,819.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $128.82 / $323.59	Professional	26	$70.79	$128.82	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $363.08 / $891.25	Professional	TC	$263.03	$363.08	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $316.23	Professional		$223.87	$223.87	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $158.49	Professional	26	$52.48	$66.07	$158.49
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $416.87	Professional		$75.86	$75.86	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $707.95 / $1,380.38	Professional		$331.13	$707.95	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $102.33 / $177.83	Professional	26	$53.70	$102.33	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $602.56 / $1,258.93	Professional	TC	$263.03	$602.56	$1,258.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $630.96	Professional		$389.05	$467.74	$630.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $91.20 / $125.89	Professional	26	$79.43	$91.20	$125.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $380.19 / $512.86	Professional	TC	$316.23	$380.19	$512.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $380.19 / $954.99	Professional		$323.59	$380.19	$954.99
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $138.04	Professional	26	$60.26	$70.79	$138.04
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $309.03 / $812.83	Professional	TC	$263.03	$309.03	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $524.81 / $1,096.48	Professional		$257.04	$524.81	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $81.28 / $147.91	Professional	26	$50.12	$81.28	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $407.38 / $933.25	Professional	TC	$199.53	$407.38	$933.25