Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $74.13 / $371.54	Facility	26	$50.12	$74.13	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $275.42 / $1,000.00	Professional		$123.03	$275.42	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $60.26 / $208.93	Professional	26	$51.29	$60.26	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $177.83 / $446.68	Professional	TC	$100.00	$177.83	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $134.90 / $154.88	Professional		$79.43	$134.90	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $51.29 / $102.33	Professional	26	$41.69	$51.29	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $131.83	Professional	TC	$60.26	$95.50	$131.83
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $144.54 / $446.68	Professional		$58.88	$144.54	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	26	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $323.59 / $512.86	Professional		$151.36	$323.59	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $74.13 / $125.89	Professional	26	$40.74	$74.13	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $234.42 / $407.38	Professional	TC	$109.65	$234.42	$407.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $776.25	Professional		$199.53	$234.42	$776.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $776.25	Professional	26	$63.10	$72.44	$776.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $162.18 / $776.25	Professional	TC	$134.90	$162.18	$776.25
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $398.11	Professional		$141.25	$194.98	$398.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $60.26 / $97.72	Professional	26	$51.29	$60.26	$97.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $138.04 / $346.74	Professional	TC	$120.23	$138.04	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $446.68	Professional		$141.25	$263.03	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $117.49	Professional	26	$44.67	$67.61	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $177.83 / $316.23	Professional	TC	$95.50	$177.83	$316.23