Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.98 / $27.98 / $140.44	Facility	26	$27.98	$27.98	$140.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $138.65 / $222.66	Professional		$104.80	$138.65	$222.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.98 / $41.92 / $72.69	Professional	26	$27.98	$41.92	$72.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.22 / $95.56 / $146.69	Professional	TC	$77.22	$95.56	$146.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $46.16 / $100.76	Professional	26	$38.81	$46.16	$100.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $22.69 / $22.69	Facility	26	$22.69	$22.69	$22.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.64 / $168.92 / $303.55	Professional		$110.64	$168.92	$303.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.80 / $46.00 / $81.39	Professional	26	$31.80	$46.00	$81.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.70 / $124.82 / $228.72	Professional	TC	$71.70	$124.82	$228.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $169.95 / $209.36 / $283.89	Professional		$169.95	$209.36	$283.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.52 / $63.95 / $86.89	Professional	26	$54.52	$63.95	$86.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.87 / $145.43 / $196.99	Professional	TC	$120.87	$145.43	$196.99
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.99 / $150.58 / $225.83	Professional		$127.99	$150.58	$225.83
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.34 / $48.63 / $98.45	Professional	26	$41.34	$48.63	$98.45
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.66 / $106.11 / $164.08	Professional	TC	$86.66	$106.11	$164.08
United Facility/Professional Professional Modifier Low / Median / High Price $98.28 / $156.63 / $281.36	Professional		$98.28	$156.63	$281.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.02 / $52.92 / $86.85	Professional	26	$30.02	$52.92	$86.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.16 / $117.17 / $207.24	Professional	TC	$76.16	$117.17	$207.24