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 $342.85 / $425.00 / $900.00	Professional		$342.85	$425.00	$900.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.96 / $126.00 / $145.02	Professional	26	$82.96	$126.00	$145.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $637.50 / $637.50 / $637.50	Professional	50	$637.50	$637.50	$637.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $256.94 / $299.00 / $484.30	Professional	TC	$256.94	$299.00	$484.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $140.60 / $140.60 / $140.60	Professional	26	$140.60	$140.60	$140.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.71 / $59.71 / $59.71	Facility	26	$59.71	$59.71	$59.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.69 / $572.66 / $966.96	Professional		$296.69	$572.66	$966.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.44 / $107.43 / $181.86	Professional	26	$60.44	$107.43	$181.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.29 / $462.19 / $808.50	Professional	TC	$228.29	$462.19	$808.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $400.29 / $532.29 / $1,378.57	Professional		$400.29	$532.29	$1,378.57
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.01 / $111.85 / $1,215.32	Professional	26	$96.01	$111.85	$1,215.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $303.64 / $365.14 / $1,215.32	Professional	TC	$303.64	$365.14	$1,215.32
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.14 / $380.18 / $670.78	Professional		$323.14	$380.18	$670.78
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.65 / $84.29 / $119.40	Professional	26	$71.65	$84.29	$119.40
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.52 / $295.89 / $513.23	Professional	TC	$251.52	$295.89	$513.23
United Facility/Professional Professional Modifier Low / Median / High Price $271.39 / $470.43 / $749.64	Professional		$271.39	$470.43	$749.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.64 / $93.48 / $167.37	Professional	26	$62.64	$93.48	$167.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.48 / $374.84 / $617.83	Professional	TC	$204.48	$374.84	$617.83