Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.55 / $425.00 / $677.00	Professional		$276.55	$425.00	$677.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.09 / $119.21 / $145.65	Professional	26	$80.09	$119.21	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.05 / $299.00 / $469.92	Professional	TC	$192.05	$299.00	$469.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.33 / $202.92 / $202.92	Professional		$162.33	$202.92	$202.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Professional	26	$62.89	$62.89	$62.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $142.76 / $142.76 / $142.76	Professional		$142.76	$142.76	$142.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.88 / $56.88 / $56.88	Facility	26	$56.88	$56.88	$56.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.66 / $605.72 / $972.71	Professional		$274.66	$605.72	$972.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $103.24 / $172.92	Professional	26	$58.53	$103.24	$172.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.62 / $469.37 / $819.12	Professional	TC	$215.62	$469.37	$819.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $318.45 / $422.58 / $1,484.52	Professional		$318.45	$422.58	$1,484.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.63 / $107.15 / $146.21	Professional	26	$91.63	$107.15	$146.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.06 / $271.83 / $368.76	Professional	TC	$226.06	$271.83	$368.76
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.80 / $304.47 / $590.28	Professional		$258.80	$304.47	$590.28
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.17 / $81.38 / $143.58	Professional	26	$69.17	$81.38	$143.58
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $189.63 / $223.09 / $393.62	Professional	TC	$189.63	$223.09	$393.62
United Facility/Professional Professional Modifier Low / Median / High Price $217.16 / $383.61 / $685.34	Professional		$217.16	$383.61	$685.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.62 / $93.55 / $168.68	Professional	26	$68.62	$93.55	$168.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.20 / $307.70 / $565.86	Professional	TC	$169.20	$307.70	$565.86