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 $336.37 / $475.00 / $920.00	Professional		$336.37	$475.00	$920.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.90 / $126.00 / $177.81	Professional	26	$70.90	$126.00	$177.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $331.17 / $565.00	Professional	TC	$259.35	$331.17	$565.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.99 / $61.30 / $144.82	Professional	26	$51.99	$61.30	$144.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $75.23 / $420.31	Professional		$75.23	$75.23	$420.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $59.00 / $59.00	Facility	26	$59.00	$59.00	$59.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.84 / $891.90 / $1,459.60	Professional		$372.84	$891.90	$1,459.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.94 / $99.15 / $176.66	Professional	26	$50.94	$99.15	$176.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $308.98 / $747.29 / $1,307.69	Professional	TC	$308.98	$747.29	$1,307.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $392.58 / $522.35 / $2,277.80	Professional		$392.58	$522.35	$2,277.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.45 / $91.71 / $125.20	Professional	26	$78.45	$91.71	$125.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $313.48 / $376.98 / $511.32	Professional	TC	$313.48	$376.98	$511.32
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $311.44 / $366.40 / $831.61	Professional		$311.44	$366.40	$831.61
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.32 / $69.79 / $117.83	Professional	26	$59.32	$69.79	$117.83
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.12 / $296.61 / $610.84	Professional	TC	$252.12	$296.61	$610.84
United Facility/Professional Professional Modifier Low / Median / High Price $262.47 / $526.29 / $1,026.86	Professional		$262.47	$526.29	$1,026.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.81 / $80.23 / $144.69	Professional	26	$48.81	$80.23	$144.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.11 / $409.12 / $891.02	Professional	TC	$211.11	$409.12	$891.02