Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $81.28 / $380.19	Facility	26	$52.48	$81.28	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $1,023.29	Professional		$229.09	$338.84	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $223.87	Professional	26	$53.70	$85.11	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $239.88 / $537.03	Professional	TC	$158.49	$239.88	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $223.87	Professional		$154.88	$186.21	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $56.23 / $114.82	Professional	26	$46.77	$56.23	$114.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $199.53 / $281.84	Professional		$102.33	$199.53	$281.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	26	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $588.84	Professional		$194.98	$346.74	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $134.90	Professional	26	$43.65	$75.86	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $263.03 / $467.74	Professional	TC	$144.54	$263.03	$467.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $758.58	Professional		$275.42	$331.13	$758.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $758.58	Professional	26	$69.18	$79.43	$758.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $758.58	Professional	TC	$208.93	$251.19	$758.58
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $467.74	Professional		$213.80	$251.19	$467.74
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $104.71	Professional	26	$52.48	$61.66	$104.71
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $346.74	Professional	TC	$158.49	$190.55	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $512.86	Professional		$194.98	$302.00	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $120.23	Professional	26	$46.77	$69.18	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $229.09 / $398.11	Professional	TC	$144.54	$229.09	$398.11