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 $282.74 / $475.00 / $892.19	Professional		$282.74	$475.00	$892.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.12 / $119.21 / $166.95	Professional	26	$65.12	$119.21	$166.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.61 / $335.00 / $455.72	Professional	TC	$220.61	$335.00	$455.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.66 / $226.14 / $311.10	Professional		$197.66	$226.14	$311.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.37 / $55.64 / $60.76	Professional	26	$49.37	$55.64	$60.76
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $334.04 / $334.04 / $633.78	Professional		$334.04	$334.04	$633.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.19 / $44.19 / $44.19	Facility	26	$44.19	$44.19	$44.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.35 / $529.54 / $913.09	Professional		$274.35	$529.54	$913.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.83 / $80.58 / $135.90	Professional	26	$45.83	$80.58	$135.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $217.82 / $441.00 / $784.77	Professional	TC	$217.82	$441.00	$784.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $358.12 / $476.24 / $1,302.07	Professional		$358.12	$476.24	$1,302.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.01 / $84.28 / $114.87	Professional	26	$72.01	$84.28	$114.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $285.48 / $343.39 / $465.47	Professional	TC	$285.48	$343.39	$465.47
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.10 / $293.06 / $545.40	Professional		$249.10	$293.06	$545.40
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.03 / $63.57 / $88.26	Professional	26	$54.03	$63.57	$88.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.07 / $229.49 / $442.98	Professional	TC	$195.07	$229.49	$442.98
United Facility/Professional Professional Modifier Low / Median / High Price $273.99 / $433.64 / $715.60	Professional		$273.99	$433.64	$715.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.38 / $71.27 / $127.96	Professional	26	$53.38	$71.27	$127.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.60 / $360.68 / $593.07	Professional	TC	$212.60	$360.68	$593.07