Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $69.18 / $316.23	Facility	26	$46.77	$69.18	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $758.58	Professional		$131.83	$239.88	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $162.18	Professional	26	$43.65	$52.48	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $338.84	Professional	TC	$83.18	$141.25	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $125.89	Professional		$87.10	$104.71	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $44.67 / $79.43	Professional	26	$36.31	$44.67	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $75.86 / $104.71	Professional	TC	$44.67	$75.86	$104.71
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $85.11 / $245.47	Professional		$48.98	$85.11	$245.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $263.03 / $436.52	Professional		$128.82	$263.03	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $64.57 / $109.65	Professional	26	$35.48	$64.57	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $186.21 / $331.13	Professional	TC	$89.13	$186.21	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $660.69	Professional		$154.88	$186.21	$660.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $63.10 / $660.69	Professional	26	$54.95	$63.10	$660.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $123.03 / $660.69	Professional	TC	$102.33	$123.03	$660.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $316.23	Professional		$128.82	$158.49	$316.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $47.86 / $83.18	Professional	26	$40.74	$47.86	$83.18
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $109.65 / $245.47	Professional	TC	$93.33	$109.65	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $363.08	Professional		$112.20	$208.93	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $56.23 / $97.72	Professional	26	$38.02	$56.23	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $144.54 / $263.03	Professional	TC	$72.44	$144.54	$263.03