Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $104.71 / $281.84	Facility	26	$20.42	$104.71	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $309.03	Professional		$70.79	$112.20	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $43.65 / $134.90	Professional	26	$15.85	$43.65	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $64.57 / $218.78	Professional	TC	$40.74	$64.57	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $36.31 / $87.10	Professional	26	$33.88	$36.31	$87.10
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $87.10 / $158.49	Professional		$48.98	$87.10	$158.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.02 / $12.02	Facility	26	$12.02	$12.02	$12.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $501.19	Professional		$77.62	$147.91	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $28.84 / $75.86	Professional	26	$17.78	$28.84	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $107.15 / $467.74	Professional	TC	$41.69	$107.15	$467.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $1,698.24	Professional		$112.20	$144.54	$1,698.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $60.26 / $83.18	Professional	26	$52.48	$60.26	$83.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $100.00	Professional	TC	$61.66	$74.13	$100.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $218.78	Professional		$89.13	$107.15	$218.78
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $45.71 / $75.86	Professional	26	$36.31	$45.71	$75.86
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $70.79 / $154.88	Professional	TC	$52.48	$70.79	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $131.83 / $436.52	Professional		$72.44	$131.83	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $37.15 / $75.86	Professional	26	$16.22	$37.15	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $77.62 / $371.54	Professional	TC	$39.81	$77.62	$371.54