Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.54 / $39.54 / $197.81	Facility	26	$39.54	$39.54	$197.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.09 / $142.49 / $233.94	Professional		$113.09	$142.49	$233.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.54 / $48.07 / $71.67	Professional	26	$39.54	$48.07	$71.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $92.45 / $152.69	Professional	TC	$67.75	$92.45	$152.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $42.18 / $42.69	Professional	26	$34.79	$42.18	$42.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.98 / $31.98 / $31.98	Facility	26	$31.98	$31.98	$31.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $202.67 / $361.74	Professional		$109.75	$202.67	$361.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $56.85 / $96.01	Professional	26	$32.22	$56.85	$96.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.11 / $144.30 / $253.38	Professional	TC	$74.11	$144.30	$253.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $205.25 / $465.34	Professional		$154.88	$205.25	$465.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.54 / $58.94 / $80.65	Professional	26	$50.54	$58.94	$80.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.95 / $125.05 / $169.46	Professional	TC	$103.95	$125.05	$169.46
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.20 / $123.76 / $187.59	Professional		$105.20	$123.76	$187.59
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $45.27 / $58.95	Professional	26	$38.47	$45.27	$58.95
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.72 / $78.48 / $136.13	Professional	TC	$66.72	$78.48	$136.13
United Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $172.33 / $280.61	Professional		$117.29	$172.33	$280.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.69 / $52.04 / $86.61	Professional	26	$35.69	$52.04	$86.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.63 / $121.66 / $198.03	Professional	TC	$76.63	$121.66	$198.03