Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $389.05 / $660.69	Facility	26	$93.33	$389.05	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $933.25	Professional		$239.88	$371.54	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $295.12	Professional	26	$72.44	$109.65	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $229.09 / $562.34	Professional	TC	$158.49	$229.09	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $295.12	Professional		$173.78	$173.78	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $75.86 / $107.15	Professional	26	$39.81	$75.86	$107.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	TC	$229.09	$229.09	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $851.14	Professional		$251.19	$467.74	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $109.65 / $181.97	Professional	26	$61.66	$109.65	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $354.81 / $676.08	Professional	TC	$186.21	$354.81	$676.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $501.19	Professional		$316.23	$371.54	$501.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $154.88	Professional	26	$97.72	$112.20	$154.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $257.04 / $354.81	Professional	TC	$213.80	$257.04	$354.81
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $630.96	Professional		$223.87	$275.42	$630.96
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $147.91	Professional	26	$74.13	$87.10	$147.91
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $489.78	Professional	TC	$158.49	$190.55	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $426.58 / $724.44	Professional		$257.04	$426.58	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $169.82	Professional	26	$66.07	$100.00	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $309.03 / $549.54	Professional	TC	$186.21	$309.03	$549.54