Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.23 / $425.00 / $662.35	Professional		$311.23	$425.00	$662.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.91 / $119.21 / $145.65	Professional	26	$79.91	$119.21	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.44 / $299.00 / $533.85	Professional	TC	$226.44	$299.00	$533.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $227.73 / $288.50	Professional		$182.18	$227.73	$288.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $67.04 / $168.76	Professional	26	$62.89	$67.04	$168.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.88 / $56.88 / $56.88	Facility	26	$56.88	$56.88	$56.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.72 / $630.57 / $1,078.81	Professional		$300.72	$630.57	$1,078.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.30 / $103.24 / $172.92	Professional	26	$58.30	$103.24	$172.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.24 / $517.71 / $909.76	Professional	TC	$245.24	$517.71	$909.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $358.60 / $476.19 / $1,570.39	Professional		$358.60	$476.19	$1,570.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.63 / $107.15 / $1,385.24	Professional	26	$91.63	$107.15	$1,385.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $266.20 / $320.18 / $1,385.24	Professional	TC	$266.20	$320.18	$1,385.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.83 / $345.69 / $609.92	Professional		$277.83	$345.69	$609.92
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.17 / $81.38 / $129.43	Professional	26	$69.17	$81.38	$129.43
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $224.67 / $264.32 / $471.89	Professional	TC	$224.67	$264.32	$471.89
United Facility/Professional Professional Modifier Low / Median / High Price $270.00 / $480.42 / $808.99	Professional		$270.00	$480.42	$808.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.62 / $93.54 / $162.35	Professional	26	$68.62	$93.54	$162.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.46 / $319.35 / $620.97	Professional	TC	$183.46	$319.35	$620.97