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 $297.56 / $467.29 / $1,193.00	Professional		$297.56	$467.29	$1,193.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $130.00 / $322.00	Professional	26	$85.00	$130.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.44 / $299.00 / $565.00	Professional	TC	$240.44	$299.00	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.70 / $254.71 / $302.07	Professional		$234.70	$254.71	$302.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.22 / $84.22 / $189.18	Professional	26	$75.22	$84.22	$189.18
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $183.49 / $2,242.50	Professional		$116.00	$183.49	$2,242.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.48 / $70.48 / $70.48	Facility	26	$70.48	$70.48	$70.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.60 / $790.05 / $1,477.37	Professional		$321.60	$790.05	$1,477.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.18 / $124.73 / $213.48	Professional	26	$72.18	$124.73	$213.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.79 / $629.85 / $1,281.59	Professional	TC	$230.79	$629.85	$1,281.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $399.64 / $530.66 / $2,209.62	Professional		$399.64	$530.66	$2,209.62
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 $283.51 / $341.03 / $462.26	Professional	TC	$283.51	$341.03	$462.26
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.33 / $382.74 / $762.19	Professional		$325.33	$382.74	$762.19
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.25 / $100.29 / $159.51	Professional	26	$85.25	$100.29	$159.51
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.08 / $282.45 / $585.42	Professional	TC	$240.08	$282.45	$585.42
United Facility/Professional Professional Modifier Low / Median / High Price $304.64 / $551.05 / $992.20	Professional		$304.64	$551.05	$992.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.30 / $104.17 / $190.04	Professional	26	$75.30	$104.17	$190.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.66 / $393.95 / $816.77	Professional	TC	$225.66	$393.95	$816.77