Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $138.05 / $320.42	Facility	26	$119.20	$138.05	$320.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.61 / $475.00 / $1,111.50	Professional		$328.61	$475.00	$1,111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.12 / $140.00 / $320.42	Professional	26	$109.12	$140.00	$320.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.93 / $335.00 / $462.42	Professional	TC	$217.93	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.13 / $242.66 / $288.11	Professional		$194.13	$242.66	$288.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.13 / $100.93 / $200.59	Professional	26	$81.13	$100.93	$200.59
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $182.40 / $377.00 / $1,100.00	Professional		$182.40	$377.00	$1,100.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $126.08 / $176.74 / $286.45	Professional	26	$126.08	$176.74	$286.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.61 / $84.61 / $84.61	Facility	26	$84.61	$84.61	$84.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.58 / $650.29 / $1,479.01	Professional		$284.58	$650.29	$1,479.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.13 / $142.50 / $235.57	Professional	26	$78.13	$142.50	$235.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.73 / $469.66 / $1,260.10	Professional	TC	$193.73	$469.66	$1,260.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $379.34 / $503.35 / $2,226.26	Professional		$379.34	$503.35	$2,226.26
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.02 / $143.28 / $2,539.79	Professional	26	$123.02	$143.28	$2,539.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $255.57 / $307.38 / $2,539.79	Professional	TC	$255.57	$307.38	$2,539.79
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.81 / $359.78 / $721.11	Professional		$305.81	$359.78	$721.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.42 / $107.55 / $168.24	Professional	26	$91.42	$107.55	$168.24
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.40 / $252.24 / $457.13	Professional	TC	$214.40	$252.24	$457.13
United Facility/Professional Professional Modifier Low / Median / High Price $303.04 / $522.94 / $970.75	Professional		$303.04	$522.94	$970.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.87 / $129.02 / $213.52	Professional	26	$89.87	$129.02	$213.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.93 / $335.43 / $753.79	Professional	TC	$196.93	$335.43	$753.79