Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $416.87 / $1,584.89	Facility	26	$131.83	$416.87	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $501.19 / $2,187.76	Professional		$213.80	$501.19	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $177.83 / $512.86	Professional	26	$100.00	$177.83	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $407.38 / $1,071.52	Professional	TC	$269.15	$407.38	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $371.54	Professional		$257.04	$309.03	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $97.72 / $194.98	Professional	26	$79.43	$97.72	$194.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	TC	$354.81	$354.81	$354.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $223.87 / $1,000.00	Professional		$109.65	$223.87	$1,000.00
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 $338.84 / $707.95 / $1,380.38	Professional		$338.84	$707.95	$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 $263.03 / $549.54 / $1,096.48	Professional	TC	$263.03	$549.54	$1,096.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $549.54 / $741.31	Professional		$457.09	$549.54	$741.31
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 $338.84 / $407.38 / $549.54	Professional	TC	$338.84	$407.38	$549.54
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $467.74 / $912.01	Professional		$398.11	$467.74	$912.01
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $102.33 / $177.83	Professional	26	$87.10	$102.33	$177.83
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $363.08 / $741.31	Professional	TC	$309.03	$363.08	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $602.56 / $1,148.15	Professional		$338.84	$602.56	$1,148.15
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 $251.19 / $457.09 / $912.01	Professional	TC	$251.19	$457.09	$912.01