Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $371.54 / $588.84	Facility	26	$102.33	$371.54	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $478.63 / $1,348.96	Professional		$251.19	$478.63	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $134.90 / $371.54	Professional	26	$77.62	$134.90	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $707.95	Professional	TC	$245.47	$338.84	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $281.84 / $309.03	Professional		$275.42	$281.84	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $144.54	Professional	26	$57.54	$72.44	$144.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	TC	$398.11	$398.11	$398.11
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $676.08 / $1,258.93	Professional		$416.87	$676.08	$1,258.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $562.34 / $912.01	Professional		$275.42	$562.34	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $102.33 / $173.78	Professional	26	$56.23	$102.33	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $436.52 / $758.58	Professional	TC	$218.78	$436.52	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $446.68 / $616.60	Professional		$380.19	$446.68	$616.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $102.33 / $138.04	Professional	26	$87.10	$102.33	$138.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $346.74 / $467.74	Professional	TC	$288.40	$346.74	$467.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $380.19 / $724.44	Professional		$323.59	$380.19	$724.44
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $134.90	Professional	26	$67.61	$79.43	$134.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $575.44	Professional	TC	$251.19	$295.12	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $831.76	Professional		$281.84	$478.63	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $158.49	Professional	26	$58.88	$85.11	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $676.08	Professional	TC	$213.80	$371.54	$676.08