Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.67 / $34.85 / $143.41	Facility	26	$27.67	$34.85	$143.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.07 / $107.06 / $172.98	Professional		$86.07	$107.06	$172.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $32.52 / $51.21	Professional	26	$26.53	$32.52	$51.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.53 / $74.53 / $103.57	Professional	TC	$59.53	$74.53	$103.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $31.08 / $54.81	Professional	26	$24.72	$31.08	$54.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $129.43 / $129.43 / $129.43	Professional		$129.43	$129.43	$129.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.20 / $140.13 / $224.95	Professional		$84.20	$140.13	$224.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.82 / $41.91 / $69.40	Professional	26	$23.82	$41.91	$69.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.68 / $97.40 / $160.12	Professional	TC	$59.68	$97.40	$160.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $122.00 / $150.19 / $204.37	Professional		$122.00	$150.19	$204.37
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $43.63 / $59.88	Professional	26	$37.47	$43.63	$59.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.61 / $106.56 / $144.49	Professional	TC	$88.61	$106.56	$144.49
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $110.85 / $179.52	Professional		$73.02	$110.85	$179.52
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.53 / $33.57 / $106.29	Professional	26	$28.53	$33.57	$106.29
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.67 / $77.26 / $128.12	Professional	TC	$65.67	$77.26	$128.12
United Facility/Professional Professional Modifier Low / Median / High Price $82.87 / $120.51 / $201.16	Professional		$82.87	$120.51	$201.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.43 / $37.84 / $62.39	Professional	26	$24.43	$37.84	$62.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.79 / $84.49 / $141.93	Professional	TC	$57.79	$84.49	$141.93