Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.43 / $53.64 / $220.73	Facility	26	$44.43	$53.64	$220.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.27 / $215.51 / $413.00	Professional		$129.27	$215.51	$413.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.44 / $53.64 / $116.07	Professional	26	$44.44	$53.64	$116.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.94 / $135.35 / $240.00	Professional	TC	$79.94	$135.35	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.81 / $92.80 / $101.03	Professional		$80.81	$92.80	$101.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.04 / $45.08 / $105.47	Professional	26	$38.04	$45.08	$105.47
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $162.33 / $179.35 / $600.00	Professional		$162.33	$179.35	$600.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.84 / $35.84 / $35.84	Facility	26	$35.84	$35.84	$35.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.73 / $251.31 / $473.00	Professional		$111.73	$251.31	$473.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $64.68 / $108.73	Professional	26	$36.61	$64.68	$108.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.80 / $161.83 / $337.01	Professional	TC	$69.80	$161.83	$337.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $157.40 / $208.27 / $651.32	Professional		$157.40	$208.27	$651.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.69 / $67.45 / $654.91	Professional	26	$57.69	$67.45	$654.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.23 / $119.36 / $654.91	Professional	TC	$99.23	$119.36	$654.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $125.29 / $254.15	Professional		$76.98	$125.29	$254.15
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.32 / $50.96 / $76.42	Professional	26	$43.32	$50.96	$76.42
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.92 / $95.20 / $243.87	Professional	TC	$80.92	$95.20	$243.87
United Facility/Professional Professional Modifier Low / Median / High Price $122.70 / $201.74 / $328.56	Professional		$122.70	$201.74	$328.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.79 / $61.14 / $97.30	Professional	26	$40.79	$61.14	$97.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.09 / $124.46 / $229.74	Professional	TC	$76.09	$124.46	$229.74