Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.00 / $65.79 / $238.01	Facility	26	$47.00	$65.79	$238.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.70 / $279.89 / $495.07	Professional		$210.70	$279.89	$495.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.00 / $57.84 / $122.91	Professional	26	$47.00	$57.84	$122.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.25 / $217.46 / $348.53	Professional	TC	$159.25	$217.46	$348.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $157.63 / $170.60	Professional		$136.47	$157.63	$170.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.27 / $44.96 / $79.00	Professional	26	$40.27	$44.96	$79.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $170.95 / $170.95 / $600.00	Professional		$170.95	$170.95	$600.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.97 / $37.97 / $37.97	Facility	26	$37.97	$37.97	$37.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.59 / $338.49 / $584.54	Professional		$189.59	$338.49	$584.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $68.84 / $115.98	Professional	26	$38.95	$68.84	$115.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.55 / $264.36 / $475.27	Professional	TC	$144.55	$264.36	$475.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $269.47 / $357.96 / $770.52	Professional		$269.47	$357.96	$770.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $71.89 / $747.19	Professional	26	$61.40	$71.89	$747.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.50 / $249.63 / $747.19	Professional	TC	$207.50	$249.63	$747.19
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.66 / $233.72 / $416.79	Professional		$198.66	$233.72	$416.79
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $54.29 / $83.08	Professional	26	$46.15	$54.29	$83.08
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.52 / $179.43 / $322.24	Professional	TC	$152.52	$179.43	$322.24
United Facility/Professional Professional Modifier Low / Median / High Price $197.97 / $294.48 / $476.63	Professional		$197.97	$294.48	$476.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.04 / $65.11 / $110.11	Professional	26	$45.04	$65.11	$110.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.72 / $224.08 / $371.94	Professional	TC	$146.72	$224.08	$371.94