Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $416.87 / $758.58	Facility	26	$147.91	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $1,445.44	Professional		$346.74	$501.19	$1,445.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $354.81	Professional	26	$85.11	$141.25	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $354.81 / $812.83	Professional	TC	$257.04	$354.81	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $323.59	Professional		$234.42	$234.42	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	26	$75.86	$75.86	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $562.34 / $912.01	Professional		$295.12	$562.34	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $109.65 / $186.21	Professional	26	$61.66	$109.65	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $436.52 / $758.58	Professional	TC	$223.87	$436.52	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $1,202.26	Professional		$398.11	$478.63	$1,202.26
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $1,202.26	Professional	26	$95.50	$112.20	$1,202.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $363.08 / $1,202.26	Professional	TC	$302.00	$363.08	$1,202.26
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $398.11 / $741.31	Professional		$338.84	$398.11	$741.31
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $144.54	Professional	26	$72.44	$85.11	$144.54
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $316.23 / $602.56	Professional	TC	$263.03	$316.23	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $467.74 / $812.83	Professional		$263.03	$467.74	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $91.20 / $165.96	Professional	26	$60.26	$91.20	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $363.08 / $660.69	Professional	TC	$199.53	$363.08	$660.69