Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.21 / $181.69 / $518.49	Facility	26	$119.21	$181.69	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.77 / $425.00 / $677.00	Professional		$282.77	$425.00	$677.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.79 / $119.21 / $156.68	Professional	26	$82.79	$119.21	$156.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $195.98 / $299.00 / $433.05	Professional	TC	$195.98	$299.00	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $166.70 / $166.70 / $166.70	Professional		$166.70	$166.70	$166.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $65.91 / $174.14	Professional	26	$65.91	$65.91	$174.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.35 / $63.35 / $63.35	Facility	26	$63.35	$63.35	$63.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.57 / $560.88 / $1,037.49	Professional		$237.57	$560.88	$1,037.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.38 / $107.96 / $182.01	Professional	26	$60.38	$107.96	$182.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.07 / $413.27 / $895.37	Professional	TC	$166.07	$413.27	$895.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $326.73 / $433.94 / $1,517.63	Professional		$326.73	$433.94	$1,517.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.15 / $112.03 / $1,430.24	Professional	26	$96.15	$112.03	$1,430.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $230.00 / $276.58 / $1,430.24	Professional	TC	$230.00	$276.58	$1,430.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $262.89 / $309.29 / $591.08	Professional		$262.89	$309.29	$591.08
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.45 / $84.06 / $126.69	Professional	26	$71.45	$84.06	$126.69
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.45 / $225.23 / $408.17	Professional	TC	$191.45	$225.23	$408.17
United Facility/Professional Professional Modifier Low / Median / High Price $243.91 / $430.46 / $753.13	Professional		$243.91	$430.46	$753.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.06 / $96.63 / $164.05	Professional	26	$69.06	$96.63	$164.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.19 / $310.66 / $558.91	Professional	TC	$177.19	$310.66	$558.91