Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.85 / $43.85 / $226.94	Facility	26	$43.85	$43.85	$226.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.79 / $212.87 / $323.48	Professional		$172.79	$212.87	$323.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $50.23 / $72.73	Professional	26	$42.06	$50.23	$72.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.54 / $160.63 / $215.29	Professional	TC	$131.54	$160.63	$215.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $60.13 / $60.13	Professional		$60.13	$60.13	$60.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $49.32 / $49.32	Professional	26	$49.32	$49.32	$49.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.18 / $285.89 / $494.21	Professional		$166.18	$285.89	$494.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.82 / $65.86 / $110.31	Professional	26	$37.82	$65.86	$110.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.02 / $213.69 / $373.14	Professional	TC	$128.02	$213.69	$373.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $236.93 / $293.00 / $510.91	Professional		$236.93	$293.00	$510.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.44 / $68.36 / $93.24	Professional	26	$58.44	$68.36	$93.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.99 / $214.08 / $290.25	Professional	TC	$177.99	$214.08	$290.25
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.29 / $228.58 / $346.38	Professional		$194.29	$228.58	$346.38
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.50 / $52.35 / $83.26	Professional	26	$44.50	$52.35	$83.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.80 / $176.24 / $259.83	Professional	TC	$149.80	$176.24	$259.83
United Facility/Professional Professional Modifier Low / Median / High Price $177.01 / $244.91 / $448.46	Professional		$177.01	$244.91	$448.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $58.57 / $100.88	Professional	26	$42.06	$58.57	$100.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.24 / $192.24 / $348.34	Professional	TC	$133.24	$192.24	$348.34