Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $199.53 / $363.08	Facility	26	$69.18	$199.53	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $1,122.02	Professional		$213.80	$316.23	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $162.18	Professional	26	$51.29	$69.18	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $223.87 / $478.63	Professional	TC	$158.49	$223.87	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $165.96 / $218.78	Professional		$154.88	$165.96	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $53.70 / $107.15	Professional	26	$44.67	$53.70	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	26	$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $389.05 / $645.65	Professional		$213.80	$389.05	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $74.13 / $128.82	Professional	26	$41.69	$74.13	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $309.03 / $537.03	Professional	TC	$169.82	$309.03	$537.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $891.25	Professional		$281.84	$338.84	$891.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $75.86 / $891.25	Professional	26	$66.07	$75.86	$891.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $257.04 / $891.25	Professional	TC	$213.80	$257.04	$891.25
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $524.81	Professional		$208.93	$245.47	$524.81
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $58.88 / $100.00	Professional	26	$50.12	$58.88	$100.00
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $398.11	Professional	TC	$158.49	$190.55	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $575.44	Professional		$208.93	$338.84	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $66.07 / $114.82	Professional	26	$44.67	$66.07	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $269.15 / $467.74	Professional	TC	$165.96	$269.15	$467.74