Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.59 / $51.59 / $257.97	Facility	26	$51.59	$51.59	$257.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.69 / $281.58 / $485.55	Professional		$187.69	$281.58	$485.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $60.63 / $87.88	Professional	26	$51.59	$60.63	$87.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.03 / $216.06 / $372.60	Professional	TC	$132.03	$216.06	$372.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.25 / $46.09 / $122.66	Professional	26	$44.25	$46.09	$122.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.83 / $41.83 / $41.83	Facility	26	$41.83	$41.83	$41.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.89 / $405.11 / $667.41	Professional		$188.89	$405.11	$667.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.17 / $75.06 / $126.68	Professional	26	$43.17	$75.06	$126.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.99 / $326.20 / $541.82	Professional	TC	$143.99	$326.20	$541.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $233.48 / $309.80 / $988.40	Professional		$233.48	$309.80	$988.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.14 / $78.45 / $107.13	Professional	26	$67.14	$78.45	$107.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.79 / $199.39 / $270.39	Professional	TC	$165.79	$199.39	$270.39
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.06 / $224.78 / $453.17	Professional		$191.06	$224.78	$453.17
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.33 / $59.21 / $94.17	Professional	26	$50.33	$59.21	$94.17
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.72 / $165.57 / $287.18	Professional	TC	$140.72	$165.57	$287.18
United Facility/Professional Professional Modifier Low / Median / High Price $188.18 / $306.23 / $523.10	Professional		$188.18	$306.23	$523.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.46 / $71.06 / $113.46	Professional	26	$47.46	$71.06	$113.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.21 / $203.27 / $387.92	Professional	TC	$117.21	$203.27	$387.92