Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.32 / $48.42 / $123.76	Facility	26	$39.32	$48.42	$123.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.51 / $129.34 / $279.64	Professional		$97.51	$129.34	$279.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.32 / $46.28 / $104.30	Professional	26	$39.32	$46.28	$104.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.60 / $74.87 / $126.98	Professional	TC	$57.60	$74.87	$126.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.89 / $108.01 / $196.40	Professional		$75.89	$108.01	$196.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.14 / $45.15 / $79.09	Professional	26	$36.14	$45.15	$79.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $100.39 / $100.39 / $100.39	Professional	TC	$100.39	$100.39	$100.39
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $81.43 / $171.85 / $352.44	Professional		$81.43	$171.85	$352.44
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $55.70 / $76.16 / $124.27	Professional	26	$55.70	$76.16	$124.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $164.89 / $284.89	Professional		$95.54	$164.89	$284.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.93 / $62.94 / $106.11	Professional	26	$33.93	$62.94	$106.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.39 / $98.61 / $167.24	Professional	TC	$57.39	$98.61	$167.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $132.29 / $160.78 / $345.28	Professional		$132.29	$160.78	$345.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.94 / $61.79 / $132.94	Professional	26	$50.94	$61.79	$132.94
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.36 / $98.99 / $212.35	Professional	TC	$81.36	$98.99	$212.35
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.05 / $119.10 / $178.62	Professional		$89.05	$119.10	$178.62
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $47.80 / $134.56	Professional	26	$39.65	$47.80	$134.56
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.57 / $74.39 / $126.25	Professional	TC	$61.57	$74.39	$126.25
United Facility/Professional Professional Modifier Low / Median / High Price $85.66 / $128.62 / $235.09	Professional		$85.66	$128.62	$235.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $53.44 / $90.67	Professional	26	$34.36	$53.44	$90.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.04 / $86.67 / $144.41	Professional	TC	$55.04	$86.67	$144.41