Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.88 / $75.97 / $279.45	Facility	26	$55.88	$75.97	$279.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.16 / $305.62 / $600.00	Professional		$188.16	$305.62	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $62.95 / $133.97	Professional	26	$55.00	$62.95	$133.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.33 / $230.94 / $358.73	Professional	TC	$132.33	$230.94	$358.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.28 / $148.25 / $200.81	Professional		$129.28	$148.25	$200.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.46 / $48.56 / $63.26	Professional	26	$43.46	$48.56	$63.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $63.72 / $196.90 / $295.35	Professional		$63.72	$196.90	$295.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.13 / $45.13 / $45.13	Facility	26	$45.13	$45.13	$45.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.74 / $410.06 / $662.15	Professional		$186.74	$410.06	$662.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.14 / $79.59 / $136.94	Professional	26	$43.14	$79.59	$136.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.21 / $326.20 / $542.38	Professional	TC	$142.21	$326.20	$542.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $232.73 / $308.86 / $998.96	Professional		$232.73	$308.86	$998.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.41 / $77.59 / $952.00	Professional	26	$66.41	$77.59	$952.00
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.79 / $199.39 / $952.00	Professional	TC	$165.79	$199.39	$952.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.18 / $227.27 / $458.91	Professional		$193.18	$227.27	$458.91
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $64.55 / $90.34	Professional	26	$54.87	$64.55	$90.34
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.31 / $162.72 / $287.11	Professional	TC	$138.31	$162.72	$287.11
United Facility/Professional Professional Modifier Low / Median / High Price $195.03 / $324.55 / $518.75	Professional		$195.03	$324.55	$518.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.55 / $77.23 / $123.45	Professional	26	$53.55	$77.23	$123.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.57 / $210.72 / $387.20	Professional	TC	$121.57	$210.72	$387.20