Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $288.40 / $457.09	Facility	26	$158.49	$288.40	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $616.60	Professional		$181.97	$275.42	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $138.04	Professional	26	$51.29	$64.57	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $199.53 / $389.05	Professional	TC	$128.82	$199.53	$389.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $109.65	Professional	26	$44.67	$54.95	$109.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	26	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $630.96	Professional		$186.21	$380.19	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $77.62 / $134.90	Professional	26	$43.65	$77.62	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $288.40 / $512.86	Professional	TC	$141.25	$288.40	$512.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $380.19	Professional		$234.42	$281.84	$380.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $109.65	Professional	26	$69.18	$79.43	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $269.15	Professional	TC	$165.96	$199.53	$269.15
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $501.19	Professional		$199.53	$234.42	$501.19
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $60.26 / $104.71	Professional	26	$51.29	$60.26	$104.71
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $173.78 / $371.54	Professional	TC	$147.91	$173.78	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $309.03 / $537.03	Professional		$165.96	$309.03	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $117.49	Professional	26	$46.77	$67.61	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $229.09 / $416.87	Professional	TC	$117.49	$229.09	$416.87