Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $112.20 / $199.53	Facility	26	$27.54	$112.20	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $263.03	Professional		$83.18	$123.03	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $27.54 / $70.79	Professional	26	$20.89	$27.54	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $97.72 / $213.80	Professional	TC	$69.18	$97.72	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $91.20	Professional		$83.18	$83.18	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.12 / $43.65	Professional	26	$20.89	$25.12	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $17.78 / $17.78	Facility	26	$17.78	$17.78	$17.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $234.42	Professional		$91.20	$134.90	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.11 / $56.23	Professional	26	$20.42	$33.11	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $100.00 / $181.97	Professional	TC	$69.18	$100.00	$181.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $263.03	Professional		$162.18	$194.98	$263.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $36.31 / $50.12	Professional	26	$31.62	$36.31	$50.12
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $154.88 / $213.80	Professional	TC	$128.82	$154.88	$213.80
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $234.42	Professional		$104.71	$123.03	$234.42
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.30 / $57.54	Professional	26	$22.39	$26.30	$57.54
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $97.72 / $177.83	Professional	TC	$83.18	$97.72	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $218.78	Professional		$87.10	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.18 / $48.98	Professional	26	$19.50	$28.18	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $169.82	Professional	TC	$67.61	$95.50	$169.82