Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $136.63 / $1,600.00	Facility	26	$119.20	$136.63	$1,600.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.00 / $475.00 / $1,158.00	Professional		$343.00	$475.00	$1,158.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.26 / $130.31 / $231.60	Professional	26	$100.26	$130.31	$231.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.77 / $335.00 / $565.00	Professional	TC	$259.77	$335.00	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.40 / $266.95 / $331.50	Professional		$231.40	$266.95	$331.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.14 / $95.75 / $168.88	Professional	26	$76.14	$95.75	$168.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $174.32 / $225.55 / $506.34	Professional		$174.32	$225.55	$506.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $70.73 / $70.73	Facility	26	$70.73	$70.73	$70.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.63 / $766.91 / $1,431.85	Professional		$352.63	$766.91	$1,431.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.18 / $128.60 / $213.48	Professional	26	$72.18	$128.60	$213.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.99 / $587.97 / $1,239.39	Professional	TC	$265.99	$587.97	$1,239.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $455.53 / $605.29 / $2,147.00	Professional		$455.53	$605.29	$2,147.00
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 $339.39 / $408.31 / $553.21	Professional	TC	$339.39	$408.31	$553.21
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $377.29 / $443.87 / $797.26	Professional		$377.29	$443.87	$797.26
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.55 / $100.65 / $141.21	Professional	26	$85.55	$100.65	$141.21
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $291.74 / $343.22 / $545.88	Professional	TC	$291.74	$343.22	$545.88
United Facility/Professional Professional Modifier Low / Median / High Price $369.14 / $613.79 / $1,077.09	Professional		$369.14	$613.79	$1,077.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.90 / $117.89 / $208.45	Professional	26	$85.90	$117.89	$208.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.58 / $453.22 / $846.59	Professional	TC	$261.58	$453.22	$846.59