Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,158.00	Professional		$370.50	$475.00	$1,158.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.38 / $126.00 / $181.69	Professional	26	$104.38	$126.00	$181.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $676.27	Professional	TC	$259.35	$335.00	$676.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $307.47 / $352.94 / $416.61	Professional		$307.47	$352.94	$416.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.89 / $88.37 / $217.42	Professional	26	$79.89	$88.37	$217.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.04 / $74.04 / $74.04	Facility	26	$74.04	$74.04	$74.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.29 / $913.25 / $1,633.94	Professional		$431.29	$913.25	$1,633.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.02 / $135.00 / $224.58	Professional	26	$76.02	$135.00	$224.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $332.50 / $744.18 / $1,390.79	Professional	TC	$332.50	$744.18	$1,390.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $556.54 / $740.34 / $2,368.09	Professional		$556.54	$740.34	$2,368.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.14 / $141.04 / $2,432.89	Professional	26	$121.14	$141.04	$2,432.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $434.69 / $522.94 / $2,432.89	Professional	TC	$434.69	$522.94	$2,432.89
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $408.97 / $481.14 / $848.90	Professional		$408.97	$481.14	$848.90
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.48 / $105.27 / $157.88	Professional	26	$89.48	$105.27	$157.88
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $319.49 / $375.87 / $643.71	Professional	TC	$319.49	$375.87	$643.71
United Facility/Professional Professional Modifier Low / Median / High Price $416.70 / $752.86 / $1,321.36	Professional		$416.70	$752.86	$1,321.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.08 / $117.32 / $202.79	Professional	26	$86.08	$117.32	$202.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.45 / $510.52 / $920.60	Professional	TC	$300.45	$510.52	$920.60