Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $104.71 / $295.12	Facility	26	$46.77	$104.71	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $223.87 / $831.76	Professional		$131.83	$223.87	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $60.26 / $169.82	Professional	26	$43.65	$60.26	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $138.04 / $323.59	Professional	TC	$83.18	$138.04	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $89.13 / $93.33	Professional		$85.11	$89.13	$93.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $39.81 / $79.43	Professional	26	$34.67	$39.81	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $109.65	Professional	TC	$77.62	$77.62	$109.65
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $407.38	Professional		$234.42	$234.42	$407.38
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 / $257.04 / $436.52	Professional		$128.82	$257.04	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $64.57 / $107.15	Professional	26	$35.48	$64.57	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $181.97 / $331.13	Professional	TC	$89.13	$181.97	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $251.19	Professional		$154.88	$186.21	$251.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $63.10 / $87.10	Professional	26	$54.95	$63.10	$87.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $120.23 / $165.96	Professional	TC	$100.00	$120.23	$165.96
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $316.23	Professional		$134.90	$158.49	$316.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $47.86 / $89.13	Professional	26	$40.74	$47.86	$89.13
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $109.65 / $239.88	Professional	TC	$93.33	$109.65	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $208.93 / $363.08	Professional		$109.65	$208.93	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $56.23 / $97.72	Professional	26	$37.15	$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