Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $139.31 / $518.49	Facility	26	$119.20	$139.31	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.77 / $475.00 / $1,193.00	Professional		$341.77	$475.00	$1,193.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.19 / $126.00 / $236.08	Professional	26	$102.19	$126.00	$236.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.54 / $299.00 / $565.00	Professional	TC	$239.54	$299.00	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.48 / $269.51 / $344.00	Professional		$234.48	$269.51	$344.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.67 / $98.94 / $191.92	Professional	26	$77.67	$98.94	$191.92
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $361.60 / $671.67 / $1,921.90	Professional		$361.60	$671.67	$1,921.90
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $109.67 / $196.55 / $331.13	Professional	26	$109.67	$196.55	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.04 / $74.04 / $74.04	Facility	26	$74.04	$74.04	$74.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.00 / $793.39 / $1,479.82	Professional		$335.00	$793.39	$1,479.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.75 / $131.71 / $221.87	Professional	26	$73.75	$131.71	$221.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.99 / $621.10 / $1,272.59	Professional	TC	$262.99	$621.10	$1,272.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $399.15 / $529.85 / $2,224.06	Professional		$399.15	$529.85	$2,224.06
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $137.09 / $2,459.90	Professional	26	$117.61	$137.09	$2,459.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $280.76 / $337.70 / $2,459.90	Professional	TC	$280.76	$337.70	$2,459.90
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.64 / $382.93 / $721.11	Professional		$294.64	$382.93	$721.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.23 / $102.62 / $160.80	Professional	26	$87.23	$102.62	$160.80
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.26 / $280.31 / $494.58	Professional	TC	$238.26	$280.31	$494.58
United Facility/Professional Professional Modifier Low / Median / High Price $298.00 / $548.65 / $1,003.21	Professional		$298.00	$548.65	$1,003.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.37 / $117.95 / $205.62	Professional	26	$82.37	$117.95	$205.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.95 / $389.95 / $826.07	Professional	TC	$223.95	$389.95	$826.07