Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.00 / $58.37 / $203.57	Facility	26	$47.00	$58.37	$203.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $218.09 / $389.00	Professional		$126.00	$218.09	$389.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $49.47 / $106.85	Professional	26	$44.14	$49.47	$106.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.51 / $147.47 / $240.00	Professional	TC	$82.51	$147.47	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.21 / $45.21 / $94.57	Professional		$45.21	$45.21	$94.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $37.47 / $97.36	Professional	26	$34.88	$37.47	$97.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $233.70 / $409.69 / $409.69	Professional		$233.70	$409.69	$409.69
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 $123.83 / $278.93 / $465.12	Professional		$123.83	$278.93	$465.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.38 / $62.71 / $99.81	Professional	26	$34.38	$62.71	$99.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.91 / $206.49 / $368.68	Professional	TC	$85.91	$206.49	$368.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.59 / $203.25 / $675.73	Professional		$153.59	$203.25	$675.73
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.68 / $61.75 / $83.99	Professional	26	$52.68	$61.75	$83.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.41 / $120.79 / $163.69	Professional	TC	$100.41	$120.79	$163.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $152.13 / $308.30	Professional		$129.31	$152.13	$308.30
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $46.98 / $74.72	Professional	26	$39.93	$46.98	$74.72
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 $128.84 / $221.30 / $352.46	Professional		$128.84	$221.30	$352.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.35 / $56.38 / $97.38	Professional	26	$38.35	$56.38	$97.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.98 / $139.41 / $251.78	Professional	TC	$70.98	$139.41	$251.78