Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $181.97 / $758.58	Facility	26	$134.90	$181.97	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $2,238.72	Professional		$346.74	$524.81	$2,238.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $165.96 / $489.78	Professional	26	$97.72	$165.96	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $338.84 / $1,071.52	Professional	TC	$239.88	$338.84	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $295.12 / $323.59	Professional		$234.42	$295.12	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $194.98	Professional	26	$79.43	$112.20	$194.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $199.53 / $295.12	Professional	TC	$199.53	$199.53	$295.12
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $416.87 / $1,258.93	Professional		$112.20	$416.87	$1,258.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $676.08 / $1,412.54	Professional		$331.13	$676.08	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $134.90 / $223.87	Professional	26	$75.86	$134.90	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $524.81 / $1,148.15	Professional	TC	$245.47	$524.81	$1,148.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $2,454.71	Professional		$398.11	$478.63	$2,454.71
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $138.04 / $2,454.71	Professional	26	$120.23	$138.04	$2,454.71
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $338.84 / $2,454.71	Professional	TC	$281.84	$338.84	$2,454.71
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $851.14	Professional		$323.59	$398.11	$851.14
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $177.83	Professional	26	$89.13	$104.71	$177.83
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $676.08	Professional	TC	$251.19	$295.12	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $537.03 / $1,096.48	Professional		$295.12	$537.03	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $114.82 / $218.78	Professional	26	$79.43	$114.82	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $380.19 / $891.25	Professional	TC	$208.93	$380.19	$891.25