Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.11 / $59.21 / $206.49	Facility	26	$44.11	$59.21	$206.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.06 / $210.63 / $413.00	Professional		$87.06	$210.63	$413.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.11 / $50.67 / $109.00	Professional	26	$44.11	$50.67	$109.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.08 / $169.26 / $284.99	Professional	TC	$99.08	$169.26	$284.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.58 / $121.32 / $128.44	Professional		$101.58	$121.32	$128.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $38.60 / $72.68	Professional	26	$34.61	$38.60	$72.68
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $328.10 / $520.00	Professional		$81.00	$328.10	$520.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.84 / $35.84 / $35.84	Facility	26	$35.84	$35.84	$35.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.03 / $259.33 / $460.07	Professional		$135.03	$259.33	$460.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.64 / $61.28 / $102.32	Professional	26	$33.64	$61.28	$102.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.93 / $196.55 / $351.79	Professional	TC	$98.93	$196.55	$351.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $182.78 / $242.45 / $621.14	Professional		$182.78	$242.45	$621.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.68 / $61.75 / $568.27	Professional	26	$52.68	$61.75	$568.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.59 / $155.79 / $568.27	Professional	TC	$129.59	$155.79	$568.27
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.84 / $157.46 / $294.92	Professional		$133.84	$157.46	$294.92
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $46.98 / $68.53	Professional	26	$39.93	$46.98	$68.53
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.91 / $110.48 / $244.08	Professional	TC	$93.91	$110.48	$244.08
United Facility/Professional Professional Modifier Low / Median / High Price $144.72 / $223.11 / $359.38	Professional		$144.72	$223.11	$359.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.38 / $55.32 / $94.06	Professional	26	$37.38	$55.32	$94.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.36 / $164.92 / $262.04	Professional	TC	$105.36	$164.92	$262.04