Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $229.09 / $331.13	Facility	26	$79.43	$229.09	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $707.95	Professional		$173.78	$213.80	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $131.83	Professional	26	$41.69	$52.48	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $162.18 / $354.81	Professional	TC	$125.89	$162.18	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $48.98 / $64.57	Professional	26	$47.86	$48.98	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $288.40 / $512.86	Professional		$165.96	$288.40	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $66.07 / $112.20	Professional	26	$38.02	$66.07	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $204.17 / $371.54	Professional	TC	$128.82	$204.17	$371.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $380.19	Professional		$234.42	$281.84	$380.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $67.61 / $93.33	Professional	26	$58.88	$67.61	$93.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $213.80 / $288.40	Professional	TC	$177.83	$213.80	$288.40
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $389.05	Professional		$204.17	$239.88	$389.05
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $53.70 / $91.20	Professional	26	$45.71	$53.70	$91.20
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $186.21 / $309.03	Professional	TC	$158.49	$186.21	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $446.68	Professional		$177.83	$251.19	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $58.88 / $107.15	Professional	26	$41.69	$58.88	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $190.55 / $346.74	Professional	TC	$131.83	$190.55	$346.74