Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.00 / $39.01 / $124.53	Facility	26	$39.00	$39.01	$124.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.64 / $138.56 / $263.45	Professional		$111.64	$138.56	$263.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.42 / $45.99 / $106.19	Professional	26	$38.42	$45.99	$106.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.39 / $89.64 / $163.66	Professional	TC	$72.39	$89.64	$163.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.29 / $118.93 / $226.72	Professional		$92.29	$118.93	$226.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $44.85 / $77.98	Professional	26	$35.22	$44.85	$77.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $125.22 / $125.22 / $125.22	Professional	TC	$125.22	$125.22	$125.22
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $174.23 / $351.71	Professional		$71.42	$174.23	$351.71
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $55.70 / $55.70 / $55.70	Professional	26	$55.70	$55.70	$55.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.61 / $187.47 / $320.08	Professional		$111.61	$187.47	$320.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.20 / $63.27 / $106.11	Professional	26	$34.20	$63.27	$106.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.03 / $120.34 / $197.18	Professional	TC	$69.03	$120.34	$197.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.10 / $185.84 / $399.59	Professional		$153.10	$185.84	$399.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.33 / $62.26 / $337.59	Professional	26	$51.33	$62.26	$337.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $101.77 / $123.56 / $337.59	Professional	TC	$101.77	$123.56	$337.59
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.61 / $133.01 / $205.28	Professional		$80.61	$133.01	$205.28
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $47.80 / $139.52	Professional	26	$39.65	$47.80	$139.52
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.69 / $94.83 / $159.18	Professional	TC	$76.69	$94.83	$159.18
United Facility/Professional Professional Modifier Low / Median / High Price $103.33 / $154.19 / $264.83	Professional		$103.33	$154.19	$264.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.96 / $53.63 / $90.66	Professional	26	$34.96	$53.63	$90.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.34 / $103.66 / $178.35	Professional	TC	$68.34	$103.66	$178.35