Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $74.13 / $426.58	Facility	26	$46.77	$74.13	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $954.99	Professional		$213.80	$302.00	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $199.53	Professional	26	$51.29	$83.18	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $223.87 / $446.68	Professional	TC	$158.49	$223.87	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $218.78	Professional		$147.91	$147.91	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $48.98 / $102.33	Professional	26	$40.74	$48.98	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $112.20 / $218.78	Professional	TC	$112.20	$112.20	$218.78
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $602.56	Professional		$169.82	$257.04	$602.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $331.13 / $575.44	Professional		$190.55	$331.13	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $70.79 / $123.03	Professional	26	$39.81	$70.79	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $263.03 / $467.74	Professional	TC	$144.54	$263.03	$467.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $741.31	Professional		$269.15	$323.59	$741.31
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $741.31	Professional	26	$63.10	$72.44	$741.31
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $741.31	Professional	TC	$208.93	$251.19	$741.31
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $457.09	Professional		$208.93	$245.47	$457.09
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $56.23 / $97.72	Professional	26	$46.77	$56.23	$97.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $346.74	Professional	TC	$158.49	$190.55	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $288.40 / $489.78	Professional		$190.55	$288.40	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $109.65	Professional	26	$42.66	$63.10	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $223.87 / $398.11	Professional	TC	$144.54	$223.87	$398.11