Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.68 / $73.68 / $368.29	Facility	26	$73.68	$73.68	$368.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.09 / $370.01 / $618.64	Professional		$239.09	$370.01	$618.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.23 / $86.89 / $119.82	Professional	26	$70.23	$86.89	$119.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.53 / $256.00 / $415.82	Professional	TC	$159.53	$256.00	$415.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.72 / $65.72 / $65.72	Professional	26	$65.72	$65.72	$65.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.48 / $59.48 / $59.48	Facility	26	$59.48	$59.48	$59.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.41 / $474.64 / $896.88	Professional		$251.41	$474.64	$896.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.20 / $105.64 / $179.28	Professional	26	$60.20	$105.64	$179.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.38 / $360.59 / $716.27	Professional	TC	$184.38	$360.59	$716.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $312.83 / $415.07 / $1,231.20	Professional		$312.83	$415.07	$1,231.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.64 / $111.43 / $152.79	Professional	26	$95.64	$111.43	$152.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.56 / $260.51 / $353.02	Professional	TC	$216.56	$260.51	$353.02
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.84 / $263.33 / $485.65	Professional		$223.84	$263.33	$485.65
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.37 / $83.96 / $118.90	Professional	26	$71.37	$83.96	$118.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.47 / $179.38 / $316.49	Professional	TC	$152.47	$179.38	$316.49
United Facility/Professional Professional Modifier Low / Median / High Price $244.39 / $397.69 / $638.99	Professional		$244.39	$397.69	$638.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.43 / $99.34 / $160.41	Professional	26	$67.43	$99.34	$160.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.66 / $294.74 / $511.19	Professional	TC	$193.66	$294.74	$511.19