Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $407.38 / $645.65	Facility	26	$114.82	$407.38	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $446.68 / $1,412.54	Professional		$281.84	$446.68	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $131.83 / $281.84	Professional	26	$83.18	$131.83	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $302.00 / $660.69	Professional	TC	$190.55	$302.00	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $79.43 / $190.55	Professional	26	$63.10	$79.43	$190.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	TC	$158.49	$158.49	$158.49
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Professional		$537.03	$537.03	$537.03
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 $239.88 / $524.81 / $933.25	Professional		$239.88	$524.81	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $109.65 / $186.21	Professional	26	$61.66	$109.65	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $389.05 / $741.31	Professional	TC	$169.82	$389.05	$741.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $380.19 / $1,412.54	Professional		$323.59	$380.19	$1,412.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $1,412.54	Professional	26	$95.50	$112.20	$1,412.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $269.15 / $1,412.54	Professional	TC	$223.87	$269.15	$1,412.54
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $645.65	Professional		$269.15	$316.23	$645.65
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $147.91	Professional	26	$72.44	$85.11	$147.91
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $229.09 / $467.74	Professional	TC	$194.98	$229.09	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $416.87 / $776.25	Professional		$234.42	$416.87	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $91.20 / $173.78	Professional	26	$66.07	$91.20	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $288.40 / $588.84	Professional	TC	$165.96	$288.40	$588.84