Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $79.43 / $407.38	Facility	26	$56.23	$79.43	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $912.01	Professional		$186.21	$302.00	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $239.88	Professional	26	$54.95	$85.11	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $213.80 / $512.86	Professional	TC	$131.83	$213.80	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $134.90 / $177.83	Professional		$64.57	$134.90	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $109.65	Professional	26	$45.71	$54.95	$109.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $93.33 / $114.82	Professional	TC	$93.33	$93.33	$114.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $194.98 / $295.12	Professional		$63.10	$194.98	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $380.19 / $630.96	Professional		$181.97	$380.19	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $81.28 / $138.04	Professional	26	$43.65	$81.28	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $288.40 / $512.86	Professional	TC	$131.83	$288.40	$512.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $954.99	Professional		$234.42	$275.42	$954.99
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $77.62 / $954.99	Professional	26	$67.61	$77.62	$954.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $954.99	Professional	TC	$165.96	$199.53	$954.99
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $512.86	Professional		$199.53	$239.88	$512.86
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $66.07 / $107.15	Professional	26	$56.23	$66.07	$107.15
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $169.82 / $371.54	Professional	TC	$144.54	$169.82	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $316.23 / $537.03	Professional		$165.96	$316.23	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $72.44 / $123.03	Professional	26	$46.77	$72.44	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $218.78 / $398.11	Professional	TC	$117.49	$218.78	$398.11