Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $114.82 / $575.44	Facility	26	$77.62	$114.82	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $389.05 / $1,230.27	Professional		$239.88	$389.05	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $288.40	Professional	26	$77.62	$93.33	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $257.04 / $630.96	Professional	TC	$158.49	$257.04	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $281.84	Professional		$177.83	$229.09	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $79.43 / $147.91	Professional	26	$66.07	$79.43	$147.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $257.04	Professional	TC	$141.25	$181.97	$257.04
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $707.95	Professional		$87.10	$151.36	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $467.74 / $831.76	Professional		$234.42	$467.74	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $112.20 / $186.21	Professional	26	$63.10	$112.20	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $346.74 / $660.69	Professional	TC	$165.96	$346.74	$660.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $512.86	Professional		$316.23	$371.54	$512.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $154.88	Professional	26	$97.72	$112.20	$154.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $257.04 / $354.81	Professional	TC	$213.80	$257.04	$354.81
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $616.60	Professional		$223.87	$275.42	$616.60
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $141.25	Professional	26	$74.13	$87.10	$141.25
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $467.74	Professional	TC	$158.49	$190.55	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $398.11 / $707.95	Professional		$234.42	$398.11	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $169.82	Professional	26	$66.07	$100.00	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $512.86	Professional	TC	$165.96	$281.84	$512.86