Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.89 / $72.65 / $259.49	Facility	26	$51.89	$72.65	$259.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.09 / $303.77 / $559.88	Professional		$216.09	$303.77	$559.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.90 / $63.06 / $121.21	Professional	26	$51.90	$63.06	$121.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.25 / $237.19 / $408.74	Professional	TC	$159.25	$237.19	$408.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.47 / $199.33 / $237.22	Professional		$160.47	$199.33	$237.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $56.25 / $99.03	Professional	26	$44.73	$56.25	$99.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $102.62 / $198.65 / $282.14	Professional		$102.62	$198.65	$282.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.83 / $41.83 / $41.83	Facility	26	$41.83	$41.83	$41.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.42 / $347.01 / $616.90	Professional		$193.42	$347.01	$616.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.99 / $75.00 / $127.38	Professional	26	$42.99	$75.00	$127.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.19 / $265.77 / $496.47	Professional	TC	$144.19	$265.77	$496.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $274.01 / $363.93 / $838.16	Professional		$274.01	$363.93	$838.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.53 / $78.94 / $759.57	Professional	26	$67.53	$78.94	$759.57
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.93 / $247.73 / $759.57	Professional	TC	$205.93	$247.73	$759.57
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.45 / $239.35 / $478.99	Professional		$203.45	$239.35	$478.99
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.94 / $59.93 / $95.31	Professional	26	$50.94	$59.93	$95.31
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.52 / $179.43 / $285.37	Professional	TC	$152.52	$179.43	$285.37
United Facility/Professional Professional Modifier Low / Median / High Price $206.68 / $301.42 / $492.38	Professional		$206.68	$301.42	$492.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $70.55 / $120.61	Professional	26	$48.85	$70.55	$120.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.87 / $228.01 / $370.49	Professional	TC	$145.87	$228.01	$370.49