Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $145.61 / $518.49	Facility	26	$119.20	$145.61	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.89 / $475.00 / $1,051.29	Professional		$331.89	$475.00	$1,051.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.14 / $140.00 / $311.32	Professional	26	$107.14	$140.00	$311.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.58 / $335.00 / $462.42	Professional	TC	$218.58	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.60 / $243.15 / $245.38	Professional		$223.60	$243.15	$245.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.13 / $95.85 / $189.29	Professional	26	$81.13	$95.85	$189.29
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $188.46 / $585.00 / $1,100.00	Professional		$188.46	$585.00	$1,100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.05 / $84.05 / $84.05	Facility	26	$84.05	$84.05	$84.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.39 / $660.41 / $1,456.81	Professional		$277.39	$660.41	$1,456.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.13 / $142.04 / $244.37	Professional	26	$78.13	$142.04	$244.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.24 / $513.27 / $1,196.16	Professional	TC	$185.24	$513.27	$1,196.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $380.13 / $504.39 / $2,155.59	Professional		$380.13	$504.39	$2,155.59
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 $256.36 / $308.33 / $2,539.79	Professional	TC	$256.36	$308.33	$2,539.79
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.61 / $360.49 / $691.23	Professional		$305.61	$360.49	$691.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.42 / $107.55 / $161.30	Professional	26	$91.42	$107.55	$161.30
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $215.00 / $252.94 / $402.30	Professional	TC	$215.00	$252.94	$402.30
United Facility/Professional Professional Modifier Low / Median / High Price $258.77 / $453.85 / $970.42	Professional		$258.77	$453.85	$970.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.10 / $123.62 / $221.78	Professional	26	$82.10	$123.62	$221.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.64 / $332.91 / $755.92	Professional	TC	$195.64	$332.91	$755.92