Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.54 / $46.55 / $225.79	Facility	26	$46.54	$46.55	$225.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.51 / $170.13 / $243.85	Professional		$106.51	$170.13	$243.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $55.05 / $89.09	Professional	26	$46.51	$55.05	$89.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.66 / $100.35 / $188.44	Professional	TC	$49.66	$100.35	$188.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $96.70 / $96.70	Professional		$96.70	$96.70	$96.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.75 / $53.75 / $115.46	Professional	26	$53.75	$53.75	$115.46
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $89.77 / $126.50 / $149.00	Professional		$89.77	$126.50	$149.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.16 / $221.37 / $601.91	Professional		$98.16	$221.37	$601.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.00 / $71.84 / $119.09	Professional	26	$48.00	$71.84	$119.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.53 / $132.18 / $539.83	Professional	TC	$47.53	$132.18	$539.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $146.16 / $170.65 / $543.60	Professional		$146.16	$170.65	$543.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.84 / $87.30 / $125.68	Professional	26	$76.84	$87.30	$125.68
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.31 / $83.35 / $113.11	Professional	TC	$69.31	$83.35	$113.11
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $133.62 / $232.87	Professional		$97.56	$133.62	$232.87
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.32 / $65.08 / $103.51	Professional	26	$55.32	$65.08	$103.51
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.26 / $70.38 / $171.51	Professional	TC	$58.26	$70.38	$171.51
United Facility/Professional Professional Modifier Low / Median / High Price $95.57 / $188.32 / $472.24	Professional		$95.57	$188.32	$472.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.38 / $73.16 / $116.24	Professional	26	$44.38	$73.16	$116.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.60 / $90.54 / $211.42	Professional	TC	$45.60	$90.54	$211.42