Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $138.04 / $660.69	Facility	26	$81.28	$138.04	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $1,288.25	Professional		$309.03	$501.19	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $346.74	Professional	26	$85.11	$125.89	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $354.81 / $707.95	Professional	TC	$223.87	$354.81	$707.95
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 / $173.78	Professional	26	$79.43	$97.72	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	TC	$257.04	$257.04	$257.04
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $269.15 / $630.96	Professional		$141.25	$269.15	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $575.44 / $977.24	Professional		$302.00	$575.44	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $131.83 / $218.78	Professional	26	$74.13	$131.83	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $446.68 / $776.25	Professional	TC	$229.09	$446.68	$776.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $537.03 / $741.31	Professional		$457.09	$537.03	$741.31
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $138.04 / $186.21	Professional	26	$117.49	$138.04	$186.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $398.11 / $549.54	Professional	TC	$331.13	$398.11	$549.54
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $416.87 / $812.83	Professional		$354.81	$416.87	$812.83
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $181.97	Professional	26	$89.13	$104.71	$181.97
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $309.03 / $645.65	Professional	TC	$263.03	$309.03	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $501.19 / $870.96	Professional		$316.23	$501.19	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $204.17	Professional	26	$83.18	$117.49	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $389.05 / $691.83	Professional	TC	$234.42	$389.05	$691.83