Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.60 / $49.60 / $247.93	Facility	26	$49.60	$49.60	$247.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.99 / $306.48 / $563.50	Professional		$185.99	$306.48	$563.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $58.71 / $87.10	Professional	26	$49.60	$58.71	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.72 / $246.23 / $388.52	Professional	TC	$131.72	$246.23	$388.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.85 / $135.85 / $147.34	Professional		$135.85	$135.85	$147.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $43.93 / $117.93	Professional	26	$43.93	$43.93	$117.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $39.86 / $39.86	Facility	26	$39.86	$39.86	$39.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.31 / $383.92 / $648.08	Professional		$191.31	$383.92	$648.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.00 / $70.65 / $120.96	Professional	26	$41.00	$70.65	$120.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.52 / $308.11 / $537.54	Professional	TC	$140.52	$308.11	$537.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $231.56 / $307.14 / $945.69	Professional		$231.56	$307.14	$945.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.97 / $74.95 / $101.99	Professional	26	$63.97	$74.95	$101.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $166.97 / $200.81 / $272.32	Professional	TC	$166.97	$200.81	$272.32
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.52 / $228.85 / $439.72	Professional		$194.52	$228.85	$439.72
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.35 / $56.88 / $90.21	Professional	26	$48.35	$56.88	$90.21
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.16 / $171.96 / $420.17	Professional	TC	$146.16	$171.96	$420.17
United Facility/Professional Professional Modifier Low / Median / High Price $175.80 / $303.91 / $520.16	Professional		$175.80	$303.91	$520.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.54 / $67.20 / $113.65	Professional	26	$47.54	$67.20	$113.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.02 / $237.20 / $418.33	Professional	TC	$128.02	$237.20	$418.33