Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.32 / $61.51 / $238.01	Facility	26	$47.32	$61.51	$238.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.24 / $255.77 / $472.00	Professional		$146.24	$255.77	$472.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.32 / $57.59 / $128.22	Professional	26	$47.32	$57.59	$128.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.53 / $199.55 / $355.12	Professional	TC	$111.53	$199.55	$355.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.91 / $109.91 / $126.08	Professional		$109.91	$109.91	$126.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.75 / $48.00 / $112.21	Professional	26	$40.75	$48.00	$112.21
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $98.72 / $98.72 / $98.72	Professional		$98.72	$98.72	$98.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.97 / $37.97 / $37.97	Facility	26	$37.97	$37.97	$37.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.74 / $311.25 / $533.17	Professional		$159.74	$311.25	$533.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $68.84 / $115.98	Professional	26	$38.95	$68.84	$115.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.62 / $244.00 / $414.12	Professional	TC	$115.62	$244.00	$414.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $197.45 / $261.77 / $744.62	Professional		$197.45	$261.77	$744.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $71.89 / $97.93	Professional	26	$61.40	$71.89	$97.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $135.49 / $162.90 / $221.08	Professional	TC	$135.49	$162.90	$221.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.19 / $189.64 / $389.86	Professional		$161.19	$189.64	$389.86
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $54.29 / $95.90	Professional	26	$46.15	$54.29	$95.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.06 / $135.36 / $318.50	Professional	TC	$115.06	$135.36	$318.50
United Facility/Professional Professional Modifier Low / Median / High Price $163.50 / $249.08 / $415.01	Professional		$163.50	$249.08	$415.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.35 / $64.22 / $109.09	Professional	26	$45.35	$64.22	$109.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.85 / $169.91 / $317.14	Professional	TC	$103.85	$169.91	$317.14