Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.51 / $122.52 / $487.46	Facility	26	$87.51	$122.52	$487.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.79 / $260.36 / $380.51	Professional		$203.79	$260.36	$380.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $113.79 / $173.54	Professional	26	$87.52	$113.79	$173.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.39 / $131.72 / $220.00	Professional	TC	$99.39	$131.72	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.97 / $309.97 / $309.97	Professional		$309.97	$309.97	$309.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $106.76 / $106.76 / $106.76	Professional	26	$106.76	$106.76	$106.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.70 / $525.54 / $988.13	Professional		$309.70	$525.54	$988.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.43 / $138.79 / $237.69	Professional	26	$80.43	$138.79	$237.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.01 / $393.22 / $759.66	Professional	TC	$224.01	$393.22	$759.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $258.95 / $341.78 / $866.28	Professional		$258.95	$341.78	$866.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.57 / $149.90 / $205.39	Professional	26	$128.57	$149.90	$205.39
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.53 / $155.85 / $211.08	Professional	TC	$129.53	$155.85	$211.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.41 / $223.01 / $352.77	Professional		$138.41	$223.01	$352.77
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.65 / $112.63 / $179.93	Professional	26	$95.65	$112.63	$179.93
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.91 / $110.48 / $198.80	Professional	TC	$93.91	$110.48	$198.80
United Facility/Professional Professional Modifier Low / Median / High Price $339.65 / $531.71 / $876.75	Professional		$339.65	$531.71	$876.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.38 / $134.52 / $224.74	Professional	26	$87.38	$134.52	$224.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.85 / $389.53 / $698.99	Professional	TC	$242.85	$389.53	$698.99