Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $119.21 / $518.49	Facility	26	$119.20	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $646.92	Professional		$370.50	$475.00	$646.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $204.81	Professional	26	$111.15	$140.00	$204.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.04 / $335.00 / $460.76	Professional	TC	$249.04	$335.00	$460.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.34 / $272.92 / $289.47	Professional		$218.34	$272.92	$289.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.62 / $114.44 / $205.39	Professional	26	$82.62	$114.44	$205.39
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $179.92 / $217.41 / $217.41	Professional		$179.92	$217.41	$217.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.08 / $660.45 / $1,155.00	Professional		$318.08	$660.45	$1,155.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.42 / $151.78 / $253.66	Professional	26	$86.42	$151.78	$253.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.13 / $476.53 / $869.94	Professional	TC	$223.13	$476.53	$869.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $427.02 / $565.85 / $1,478.01	Professional		$427.02	$565.85	$1,478.01
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $137.22 / $160.46 / $218.96	Professional	26	$137.22	$160.46	$218.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.63 / $347.19 / $470.60	Professional	TC	$288.63	$347.19	$470.60
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.48 / $411.15 / $757.10	Professional		$349.48	$411.15	$757.10
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.55 / $119.47 / $190.01	Professional	26	$101.55	$119.47	$190.01
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $247.93 / $291.68 / $505.92	Professional	TC	$247.93	$291.68	$505.92
United Facility/Professional Professional Modifier Low / Median / High Price $345.93 / $579.77 / $906.71	Professional		$345.93	$579.77	$906.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.77 / $137.33 / $240.38	Professional	26	$100.77	$137.33	$240.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.08 / $387.91 / $696.30	Professional	TC	$216.08	$387.91	$696.30