Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.06 / $78.06 / $385.45	Facility	26	$78.06	$78.06	$385.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.58 / $373.86 / $618.00	Professional		$242.58	$373.86	$618.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.06 / $91.52 / $186.81	Professional	26	$78.06	$91.52	$186.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $291.75 / $471.93	Professional	TC	$162.63	$291.75	$471.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.98 / $186.98 / $186.98	Professional		$186.98	$186.98	$186.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.02 / $74.92 / $182.36	Professional	26	$69.02	$74.92	$182.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $159.60 / $159.60 / $159.60	Professional		$159.60	$159.60	$159.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.38 / $62.38 / $62.38	Facility	26	$62.38	$62.38	$62.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.83 / $506.58 / $929.13	Professional		$265.83	$506.58	$929.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.23 / $110.36 / $188.97	Professional	26	$63.23	$110.36	$188.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.48 / $386.15 / $744.33	Professional	TC	$199.48	$386.15	$744.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $317.81 / $421.68 / $1,235.72	Professional		$317.81	$421.68	$1,235.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.49 / $117.19 / $160.46	Professional	26	$100.49	$117.19	$160.46
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.61 / $260.45 / $353.40	Professional	TC	$216.61	$260.45	$353.40
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.22 / $267.32 / $490.15	Professional		$227.22	$267.32	$490.15
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.75 / $87.94 / $155.16	Professional	26	$74.75	$87.94	$155.16
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.47 / $179.38 / $338.67	Professional	TC	$152.47	$179.38	$338.67
United Facility/Professional Professional Modifier Low / Median / High Price $268.93 / $435.07 / $705.42	Professional		$268.93	$435.07	$705.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.76 / $105.60 / $185.38	Professional	26	$71.76	$105.60	$185.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.31 / $344.37 / $564.10	Professional	TC	$208.31	$344.37	$564.10