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 $344.73 / $425.00 / $697.00	Professional		$344.73	$425.00	$697.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.58 / $126.00 / $181.84	Professional	26	$82.58	$126.00	$181.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $258.58 / $299.00 / $485.57	Professional	TC	$258.58	$299.00	$485.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.45 / $65.45 / $65.45	Professional	26	$65.45	$65.45	$65.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $59.00 / $59.00	Facility	26	$59.00	$59.00	$59.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.43 / $574.15 / $965.06	Professional		$295.43	$574.15	$965.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.19 / $107.02 / $180.49	Professional	26	$60.19	$107.02	$180.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.86 / $462.19 / $808.50	Professional	TC	$229.86	$462.19	$808.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $400.33 / $532.41 / $1,375.11	Professional		$400.33	$532.41	$1,375.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.29 / $110.99 / $1,213.07	Professional	26	$95.29	$110.99	$1,213.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $304.43 / $366.08 / $1,213.07	Professional	TC	$304.43	$366.08	$1,213.07
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.11 / $381.31 / $672.78	Professional		$324.11	$381.31	$672.78
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $83.64 / $125.43	Professional	26	$71.09	$83.64	$125.43
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $253.02 / $297.67 / $483.61	Professional	TC	$253.02	$297.67	$483.61
United Facility/Professional Professional Modifier Low / Median / High Price $267.16 / $469.05 / $748.11	Professional		$267.16	$469.05	$748.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.15 / $96.15 / $158.26	Professional	26	$62.15	$96.15	$158.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $205.01 / $377.10 / $647.38	Professional	TC	$205.01	$377.10	$647.38