Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.02 / $119.21 / $518.49	Facility	26	$93.02	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.77 / $425.00 / $726.34	Professional		$202.77	$425.00	$726.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.48 / $119.21 / $189.00	Professional	26	$69.48	$119.21	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.88 / $299.00 / $441.00	Professional	TC	$132.88	$299.00	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.11 / $149.75 / $199.04	Professional		$129.11	$149.75	$199.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $60.42 / $126.53	Professional	26	$51.24	$60.42	$126.53
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $74.11 / $123.57 / $342.00	Professional		$74.11	$123.57	$342.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.74 / $47.74 / $47.74	Facility	26	$47.74	$47.74	$47.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.64 / $494.69 / $787.45	Professional		$215.64	$494.69	$787.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $87.09 / $145.88	Professional	26	$49.20	$87.09	$145.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.33 / $383.55 / $670.88	Professional	TC	$153.33	$383.55	$670.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $231.55 / $306.88 / $1,217.57	Professional		$231.55	$306.88	$1,217.57
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.34 / $90.38 / $1,160.18	Professional	26	$77.34	$90.38	$1,160.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.59 / $184.70 / $1,160.18	Professional	TC	$153.59	$184.70	$1,160.18
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.35 / $220.14 / $463.13	Professional		$151.35	$220.14	$463.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.47 / $68.79 / $117.57	Professional	26	$58.47	$68.79	$117.57
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.65 / $155.44 / $321.77	Professional	TC	$128.65	$155.44	$321.77
United Facility/Professional Professional Modifier Low / Median / High Price $176.23 / $320.33 / $554.66	Professional		$176.23	$320.33	$554.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $75.45 / $142.63	Professional	26	$54.09	$75.45	$142.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.82 / $201.28 / $433.55	Professional	TC	$110.82	$201.28	$433.55