Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.68 / $67.69 / $346.57	Facility	26	$67.68	$67.69	$346.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.64 / $293.00 / $414.39	Professional		$220.64	$293.00	$414.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.69 / $84.21 / $139.66	Professional	26	$67.69	$84.21	$139.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.65 / $191.62 / $271.23	Professional	TC	$138.65	$191.62	$271.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $77.67 / $98.84	Professional	26	$63.02	$77.67	$98.84
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $88.32 / $600.00 / $600.00	Professional		$88.32	$600.00	$600.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.93 / $319.02 / $574.71	Professional		$180.93	$319.02	$574.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.46 / $102.06 / $171.64	Professional	26	$58.46	$102.06	$171.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.24 / $214.27 / $412.30	Professional	TC	$124.24	$214.27	$412.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $269.95 / $333.17 / $555.19	Professional		$269.95	$333.17	$555.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.79 / $107.59 / $146.32	Professional	26	$91.79	$107.59	$146.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.27 / $213.08 / $289.33	Professional	TC	$177.27	$213.08	$289.33
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.52 / $242.97 / $386.44	Professional		$206.52	$242.97	$386.44
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.16 / $83.35 / $219.19	Professional	26	$69.16	$83.35	$219.19
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.36 / $165.95 / $337.30	Professional	TC	$137.36	$165.95	$337.30
United Facility/Professional Professional Modifier Low / Median / High Price $210.30 / $294.16 / $521.23	Professional		$210.30	$294.16	$521.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.33 / $97.66 / $165.27	Professional	26	$66.33	$97.66	$165.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.71 / $185.78 / $316.61	Professional	TC	$120.71	$185.78	$316.61