Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $67.61 / $125.89	Facility	26	$16.22	$67.61	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $239.88	Professional		$67.61	$109.65	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.70 / $53.70	Professional	26	$15.85	$25.70	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $75.86 / $162.18	Professional	TC	$51.29	$75.86	$162.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $89.13 / $102.33	Professional		$57.54	$89.13	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $204.17	Professional		$74.13	$112.20	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $25.70 / $41.69	Professional	26	$14.79	$25.70	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $87.10 / $162.18	Professional	TC	$56.23	$87.10	$162.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $141.25 / $190.55	Professional		$117.49	$141.25	$190.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $26.92 / $36.31	Professional	26	$22.91	$26.92	$36.31
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $114.82 / $154.88	Professional	TC	$95.50	$114.82	$154.88
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $177.83	Professional		$81.28	$100.00	$177.83
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.95 / $42.66	Professional	26	$16.98	$19.95	$42.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $79.43 / $134.90	Professional	TC	$64.57	$79.43	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $165.96	Professional		$66.07	$95.50	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.88 / $38.02	Professional	26	$14.13	$21.88	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $74.13 / $131.83	Professional	TC	$51.29	$74.13	$131.83