Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $69.18 / $316.23	Facility	26	$46.77	$69.18	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $208.93 / $831.76	Professional		$114.82	$208.93	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $162.18	Professional	26	$45.71	$54.95	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $128.82 / $389.05	Professional	TC	$79.43	$128.82	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $208.93	Professional		$91.20	$117.49	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $46.77 / $93.33	Professional	26	$38.90	$46.77	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $74.13 / $109.65	Professional	TC	$34.67	$74.13	$109.65
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $141.25 / $549.54	Professional		$54.95	$141.25	$549.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $257.04 / $446.68	Professional		$123.03	$257.04	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $67.61 / $114.82	Professional	26	$37.15	$67.61	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $181.97 / $331.13	Professional	TC	$81.28	$181.97	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $186.21 / $562.34	Professional		$158.49	$186.21	$562.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $67.61 / $562.34	Professional	26	$57.54	$67.61	$562.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $120.23 / $562.34	Professional	TC	$100.00	$120.23	$562.34
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $162.18 / $338.84	Professional		$131.83	$162.18	$338.84
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $56.23 / $91.20	Professional	26	$46.77	$56.23	$91.20
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $109.65 / $208.93	Professional	TC	$89.13	$109.65	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $213.80 / $363.08	Professional		$112.20	$213.80	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $61.66 / $104.71	Professional	26	$40.74	$61.66	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $134.90 / $251.19	Professional	TC	$70.79	$134.90	$251.19