Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.28 / $49.29 / $247.93	Facility	26	$49.28	$49.29	$247.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.49 / $288.20 / $600.00	Professional		$213.49	$288.20	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.29 / $58.30 / $87.74	Professional	26	$49.29	$58.30	$87.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.22 / $225.34 / $372.60	Professional	TC	$159.22	$225.34	$372.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.56 / $178.25 / $178.25	Professional		$150.56	$178.25	$178.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.26 / $42.77 / $54.42	Professional	26	$42.26	$42.77	$54.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $39.86 / $39.86	Facility	26	$39.86	$39.86	$39.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.70 / $396.74 / $707.12	Professional		$211.70	$396.74	$707.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.12 / $72.20 / $121.68	Professional	26	$41.12	$72.20	$121.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.12 / $320.26 / $602.27	Professional	TC	$165.12	$320.26	$602.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.52 / $373.89 / $969.09	Professional		$281.52	$373.89	$969.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $75.43 / $900.24	Professional	26	$64.37	$75.43	$900.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.56 / $260.51 / $900.24	Professional	TC	$216.56	$260.51	$900.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.12 / $236.61 / $478.82	Professional		$201.12	$236.61	$478.82
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $57.24 / $79.98	Professional	26	$48.65	$57.24	$79.98
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.47 / $179.38 / $294.33	Professional	TC	$152.47	$179.38	$294.33
United Facility/Professional Professional Modifier Low / Median / High Price $225.12 / $340.06 / $534.46	Professional		$225.12	$340.06	$534.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.60 / $66.88 / $109.29	Professional	26	$45.60	$66.88	$109.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.77 / $259.20 / $433.43	Professional	TC	$156.77	$259.20	$433.43