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 $344.12 / $475.00 / $1,102.00	Professional		$344.12	$475.00	$1,102.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.47 / $130.00 / $199.08	Professional	26	$99.47	$130.00	$199.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $260.62 / $335.00 / $565.00	Professional	TC	$260.62	$335.00	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.98 / $289.98 / $366.80	Professional		$231.98	$289.98	$366.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.22 / $95.75 / $207.94	Professional	26	$75.22	$95.75	$207.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $255.36 / $255.36 / $255.36	Professional	TC	$255.36	$255.36	$255.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $110.49 / $110.49 / $110.49	Professional		$110.49	$110.49	$110.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $70.73 / $70.73	Facility	26	$70.73	$70.73	$70.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.10 / $766.21 / $1,432.41	Professional		$353.10	$766.21	$1,432.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.40 / $128.15 / $214.24	Professional	26	$72.40	$128.15	$214.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.68 / $590.02 / $1,241.83	Professional	TC	$264.68	$590.02	$1,241.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $456.71 / $606.88 / $2,147.00	Professional		$456.71	$606.88	$2,147.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.41 / $134.46 / $184.40	Professional	26	$115.41	$134.46	$184.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $340.57 / $409.74 / $555.14	Professional	TC	$340.57	$409.74	$555.14
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $377.89 / $444.58 / $822.26	Professional		$377.89	$444.58	$822.26
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.55 / $100.65 / $153.02	Professional	26	$85.55	$100.65	$153.02
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $292.35 / $343.94 / $642.54	Professional	TC	$292.35	$343.94	$642.54
United Facility/Professional Professional Modifier Low / Median / High Price $348.66 / $614.78 / $1,078.79	Professional		$348.66	$614.78	$1,078.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.06 / $112.69 / $193.90	Professional	26	$82.06	$112.69	$193.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $262.51 / $474.38 / $848.35	Professional	TC	$262.51	$474.38	$848.35