Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.26 / $108.16 / $410.02	Facility	26	$77.26	$108.16	$410.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.87 / $402.09 / $707.77	Professional		$307.87	$402.09	$707.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.26 / $98.37 / $198.68	Professional	26	$77.26	$98.37	$198.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $231.64 / $298.64 / $499.76	Professional	TC	$231.64	$298.64	$499.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.04 / $270.01 / $346.88	Professional		$159.04	$270.01	$346.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.87 / $88.92 / $175.59	Professional	26	$69.87	$88.92	$175.59
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $211.25 / $577.37 / $1,210.44	Professional		$211.25	$577.37	$1,210.44
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $112.05 / $195.15 / $282.79	Professional	26	$112.05	$195.15	$282.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $491.80 / $858.36	Professional		$275.00	$491.80	$858.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.79 / $120.23 / $201.39	Professional	26	$68.79	$120.23	$201.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.22 / $370.20 / $666.43	Professional	TC	$204.22	$370.20	$666.43
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $401.40 / $557.85 / $976.56	Professional		$401.40	$557.85	$976.56
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.84 / $124.76 / $170.56	Professional	26	$106.84	$124.76	$170.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $293.74 / $353.34 / $478.93	Professional	TC	$293.74	$353.34	$478.93
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.22 / $376.73 / $636.58	Professional		$320.22	$376.73	$636.58
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.89 / $93.99 / $149.47	Professional	26	$79.89	$93.99	$149.47
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $226.79 / $280.45 / $406.31	Professional	TC	$226.79	$280.45	$406.31
United Facility/Professional Professional Modifier Low / Median / High Price $285.73 / $422.77 / $709.71	Professional		$285.73	$422.77	$709.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.87 / $112.74 / $187.29	Professional	26	$78.87	$112.74	$187.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.06 / $311.94 / $538.38	Professional	TC	$208.06	$311.94	$538.38