Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $416.87 / $758.58	Facility	26	$125.89	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $478.63 / $1,621.81	Professional		$165.96	$478.63	$1,621.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $169.82 / $512.86	Professional	26	$100.00	$169.82	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $912.01	Professional	TC	$245.47	$346.74	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $323.59	Professional		$223.87	$269.15	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $97.72 / $169.82	Professional	26	$75.86	$97.72	$169.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $288.40 / $302.00	Professional	TC	$204.17	$288.40	$302.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $2,238.72	Professional		$109.65	$177.83	$2,238.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $660.69 / $1,380.38	Professional		$331.13	$660.69	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $131.83 / $213.80	Professional	26	$74.13	$131.83	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $524.81 / $1,148.15	Professional	TC	$251.19	$524.81	$1,148.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $645.65	Professional		$398.11	$478.63	$645.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $134.90 / $186.21	Professional	26	$114.82	$134.90	$186.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $338.84 / $467.74	Professional	TC	$281.84	$338.84	$467.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $398.11 / $851.14	Professional		$338.84	$398.11	$851.14
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $102.33 / $173.78	Professional	26	$87.10	$102.33	$173.78
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $676.08	Professional	TC	$251.19	$295.12	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $524.81 / $1,096.48	Professional		$295.12	$524.81	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $109.65 / $208.93	Professional	26	$77.62	$109.65	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $891.25	Professional	TC	$213.80	$371.54	$891.25