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 $351.80 / $475.00 / $1,102.00	Professional		$351.80	$475.00	$1,102.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.46 / $126.00 / $189.50	Professional	26	$83.46	$126.00	$189.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $332.42 / $565.00	Professional	TC	$259.35	$332.42	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.26 / $208.26 / $238.57	Professional		$208.26	$208.26	$238.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.43 / $74.52 / $175.50	Professional	26	$65.43	$74.52	$175.50
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 $386.60 / $891.90 / $1,459.60	Professional		$386.60	$891.90	$1,459.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $107.44 / $181.21	Professional	26	$60.63	$107.44	$181.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $310.86 / $750.98 / $1,308.80	Professional	TC	$310.86	$750.98	$1,308.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $410.84 / $545.99 / $2,277.80	Professional		$410.84	$545.99	$2,277.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.35 / $111.58 / $2,166.19	Professional	26	$95.35	$111.58	$2,166.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $314.66 / $378.40 / $2,166.19	Professional	TC	$314.66	$378.40	$2,166.19
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.92 / $383.44 / $744.07	Professional		$325.92	$383.44	$744.07
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.00 / $84.70 / $134.72	Professional	26	$72.00	$84.70	$134.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $253.93 / $298.74 / $527.09	Professional	TC	$253.93	$298.74	$527.09
United Facility/Professional Professional Modifier Low / Median / High Price $283.77 / $552.27 / $1,026.50	Professional		$283.77	$552.27	$1,026.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.48 / $97.37 / $168.27	Professional	26	$62.48	$97.37	$168.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.38 / $363.98 / $869.01	Professional	TC	$201.38	$363.98	$869.01