Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.00 / $61.10 / $216.41	Facility	26	$47.00	$61.10	$216.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.04 / $218.10 / $413.00	Professional		$128.04	$218.10	$413.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $50.79 / $124.49	Professional	26	$44.14	$50.79	$124.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.83 / $160.94 / $256.00	Professional	TC	$82.83	$160.94	$256.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $85.97 / $112.44	Professional		$78.84	$85.97	$112.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.74 / $39.35 / $97.36	Professional	26	$31.74	$39.35	$97.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $51.21 / $117.35 / $330.60	Professional		$51.21	$117.35	$330.60
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $90.00 / $156.82	Professional	26	$49.40	$90.00	$156.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.97 / $37.97 / $37.97	Facility	26	$37.97	$37.97	$37.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.38 / $279.27 / $473.00	Professional		$128.38	$279.27	$473.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.38 / $63.43 / $106.63	Professional	26	$34.38	$63.43	$106.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.33 / $207.63 / $349.23	Professional	TC	$92.33	$207.63	$349.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.99 / $203.76 / $676.62	Professional		$153.99	$203.76	$676.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.68 / $61.75 / $661.67	Professional	26	$52.68	$61.75	$661.67
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.80 / $121.25 / $661.67	Professional	TC	$100.80	$121.25	$661.67
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $152.13 / $296.64	Professional		$122.23	$152.13	$296.64
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $46.98 / $71.81	Professional	26	$39.93	$46.98	$71.81
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.38 / $105.15 / $243.87	Professional	TC	$89.38	$105.15	$243.87
United Facility/Professional Professional Modifier Low / Median / High Price $116.66 / $210.50 / $353.62	Professional		$116.66	$210.50	$353.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.34 / $56.38 / $98.21	Professional	26	$37.34	$56.38	$98.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.54 / $138.86 / $254.43	Professional	TC	$78.54	$138.86	$254.43