Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.92 / $425.00 / $638.00	Professional		$257.92	$425.00	$638.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $119.21 / $157.51	Professional	26	$82.50	$119.21	$157.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.40 / $299.00 / $424.28	Professional	TC	$191.40	$299.00	$424.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.78 / $163.78 / $163.78	Professional		$163.78	$163.78	$163.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.44 / $65.67 / $80.47	Professional	26	$57.44	$65.67	$80.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.79 / $58.79 / $58.79	Facility	26	$58.79	$58.79	$58.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.94 / $553.60 / $959.64	Professional		$239.94	$553.60	$959.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.16 / $107.18 / $180.05	Professional	26	$60.16	$107.18	$180.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.38 / $405.64 / $822.56	Professional	TC	$169.38	$405.64	$822.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $320.83 / $426.06 / $1,502.09	Professional		$320.83	$426.06	$1,502.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.75 / $111.55 / $1,415.62	Professional	26	$95.75	$111.55	$1,415.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $224.49 / $269.94 / $1,415.62	Professional	TC	$224.49	$269.94	$1,415.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.66 / $304.31 / $590.28	Professional		$258.66	$304.31	$590.28
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.15 / $83.70 / $121.34	Professional	26	$71.15	$83.70	$121.34
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $187.52 / $220.61 / $365.08	Professional	TC	$187.52	$220.61	$365.08
United Facility/Professional Professional Modifier Low / Median / High Price $228.89 / $410.05 / $706.16	Professional		$228.89	$410.05	$706.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.52 / $96.22 / $167.57	Professional	26	$70.52	$96.22	$167.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.02 / $286.68 / $558.54	Professional	TC	$168.02	$286.68	$558.54