Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.00 / $60.44 / $203.57	Facility	26	$47.00	$60.44	$203.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.05 / $211.32 / $436.50	Professional		$123.05	$211.32	$436.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $50.43 / $114.33	Professional	26	$44.49	$50.43	$114.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.87 / $146.90 / $256.00	Professional	TC	$81.87	$146.90	$256.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $109.51 / $131.80	Professional		$85.81	$109.51	$131.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $41.22 / $97.36	Professional	26	$34.88	$41.22	$97.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $148.19 / $525.00	Professional		$82.65	$148.19	$525.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $56.01 / $90.00 / $125.13	Professional	26	$56.01	$90.00	$125.13
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 $127.81 / $278.57 / $473.00	Professional		$127.81	$278.57	$473.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.38 / $63.24 / $101.47	Professional	26	$34.38	$63.24	$101.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.41 / $204.78 / $349.23	Professional	TC	$91.41	$204.78	$349.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.21 / $202.72 / $674.83	Professional		$153.21	$202.72	$674.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.68 / $61.75 / $662.80	Professional	26	$52.68	$61.75	$662.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.01 / $120.31 / $662.80	Professional	TC	$100.01	$120.31	$662.80
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.25 / $151.41 / $278.79	Professional		$107.25	$151.41	$278.79
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $46.98 / $64.44	Professional	26	$39.93	$46.98	$64.44
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.77 / $104.43 / $166.10	Professional	TC	$88.77	$104.43	$166.10
United Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $203.22 / $352.01	Professional		$112.22	$203.22	$352.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.29 / $57.39 / $95.63	Professional	26	$38.29	$57.39	$95.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.98 / $140.96 / $251.88	Professional	TC	$82.98	$140.96	$251.88