Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $416.87 / $758.58	Facility	26	$125.89	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $630.96 / $2,754.23	Professional		$398.11	$630.96	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $165.96 / $426.58	Professional	26	$104.71	$165.96	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $436.52 / $933.25	Professional	TC	$281.84	$436.52	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $407.38 / $457.09	Professional		$309.03	$407.38	$457.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $83.18 / $154.88	Professional	26	$83.18	$83.18	$154.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	TC	$338.84	$338.84	$338.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $831.76 / $1,513.56	Professional		$416.87	$831.76	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $138.04 / $223.87	Professional	26	$77.62	$138.04	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $676.08 / $1,258.93	Professional	TC	$323.59	$676.08	$1,258.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $660.69 / $2,454.71	Professional		$549.54	$660.69	$2,454.71
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $141.25 / $2,454.71	Professional	26	$123.03	$141.25	$2,454.71
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $512.86 / $2,454.71	Professional	TC	$426.58	$512.86	$2,454.71
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $1,000.00	Professional		$426.58	$501.19	$1,000.00
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $107.15 / $181.97	Professional	26	$91.20	$107.15	$181.97
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $398.11 / $794.33	Professional	TC	$338.84	$398.11	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $741.31 / $1,318.26	Professional		$416.87	$741.31	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $114.82 / $218.78	Professional	26	$81.28	$114.82	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $575.44 / $1,096.48	Professional	TC	$323.59	$575.44	$1,096.48