Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $141.25 / $302.00	Facility	26	$28.84	$141.25	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $239.88	Professional		$89.13	$123.03	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $47.86 / $117.49	Professional	26	$31.62	$47.86	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Professional	26	$34.67	$34.67	$34.67
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Facility	26	$23.44	$23.44	$23.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $251.19	Professional		$79.43	$141.25	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $45.71 / $87.10	Professional	26	$32.36	$45.71	$87.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $208.93	Professional		$128.82	$151.36	$208.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $64.57 / $91.20	Professional	26	$56.23	$64.57	$91.20
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $245.47	Professional		$93.33	$114.82	$245.47
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.11 / $72.44	Professional	26	$28.18	$33.11	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $208.93	Professional		$69.18	$112.20	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $38.02 / $64.57	Professional	26	$27.54	$38.02	$64.57