Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $489.78 / $870.96	Facility	26	$123.03	$489.78	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $537.03	Professional		$204.17	$275.42	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $257.04	Professional	26	$83.18	$123.03	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $141.25 / $269.15	Professional	TC	$100.00	$141.25	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $123.03	Professional	26	$120.23	$120.23	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $512.86 / $977.24	Professional		$295.12	$512.86	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $141.25 / $239.88	Professional	26	$81.28	$141.25	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $380.19 / $758.58	Professional	TC	$213.80	$380.19	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $416.87	Professional		$257.04	$309.03	$416.87
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $151.36 / $208.93	Professional	26	$128.82	$151.36	$208.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $154.88 / $208.93	Professional	TC	$128.82	$154.88	$208.93
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $229.09 / $457.09	Professional		$190.55	$229.09	$457.09
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $114.82 / $223.87	Professional	26	$97.72	$114.82	$223.87
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $114.82 / $281.84	Professional	TC	$97.72	$114.82	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $912.01	Professional		$338.84	$512.86	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $128.82 / $218.78	Professional	26	$85.11	$128.82	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $389.05 / $707.95	Professional	TC	$251.19	$389.05	$707.95