Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.44 / $119.21 / $518.49	Facility	26	$103.44	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.06 / $425.00 / $778.18	Professional		$298.06	$425.00	$778.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.01 / $119.21 / $154.00	Professional	26	$75.01	$119.21	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.49 / $299.00 / $480.00	Professional	TC	$242.49	$299.00	$480.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.97 / $187.97 / $269.30	Professional		$187.97	$187.97	$269.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.54 / $78.64 / $159.28	Professional	26	$56.54	$78.64	$159.28
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $413.09 / $1,267.50 / $1,267.50	Professional		$413.09	$1,267.50	$1,267.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.01 / $53.01 / $53.01	Facility	26	$53.01	$53.01	$53.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.82 / $580.86 / $1,024.00	Professional		$285.82	$580.86	$1,024.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.21 / $96.94 / $162.94	Professional	26	$55.21	$96.94	$162.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.17 / $477.50 / $827.95	Professional	TC	$220.17	$477.50	$827.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $370.98 / $492.83 / $1,424.85	Professional		$370.98	$492.83	$1,424.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.30 / $101.05 / $137.63	Professional	26	$86.30	$101.05	$137.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $283.91 / $341.50 / $462.91	Professional	TC	$283.91	$341.50	$462.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.52 / $360.62 / $640.19	Professional		$306.52	$360.62	$640.19
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.23 / $76.75 / $135.41	Professional	26	$65.23	$76.75	$135.41
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.29 / $283.87 / $492.37	Professional	TC	$241.29	$283.87	$492.37
United Facility/Professional Professional Modifier Low / Median / High Price $299.13 / $467.05 / $792.41	Professional		$299.13	$467.05	$792.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.62 / $88.23 / $155.69	Professional	26	$61.62	$88.23	$155.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.51 / $374.19 / $666.51	Professional	TC	$219.51	$374.19	$666.51