Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.53 / $30.53 / $154.85	Facility	26	$30.53	$30.53	$154.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.45 / $150.97 / $286.75	Professional		$122.45	$150.97	$286.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $34.86 / $74.30	Professional	26	$28.59	$34.86	$74.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.04 / $113.70 / $207.79	Professional	TC	$93.04	$113.70	$207.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $34.04 / $34.04	Professional	26	$34.04	$34.04	$34.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.69 / $188.45 / $316.47	Professional		$113.69	$188.45	$316.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.04 / $47.80 / $78.79	Professional	26	$26.04	$47.80	$78.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.25 / $143.91 / $238.50	Professional	TC	$87.25	$143.91	$238.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $148.57 / $203.90 / $349.59	Professional		$148.57	$203.90	$349.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.13 / $47.16 / $81.39	Professional	26	$39.13	$47.16	$81.39
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.94 / $156.74 / $268.20	Professional	TC	$128.94	$156.74	$268.20
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.90 / $153.90 / $227.99	Professional		$123.90	$153.90	$227.99
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.62 / $36.89 / $173.80	Professional	26	$30.62	$36.89	$173.80
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.21 / $123.90 / $209.78	Professional	TC	$100.21	$123.90	$209.78
United Facility/Professional Professional Modifier Low / Median / High Price $107.58 / $159.33 / $292.05	Professional		$107.58	$159.33	$292.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $39.25 / $69.15	Professional	26	$26.12	$39.25	$69.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.34 / $129.77 / $227.63	Professional	TC	$84.34	$129.77	$227.63