Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $43.65 / $204.17	Facility	26	$27.54	$43.65	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $512.86	Professional		$85.11	$151.36	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $131.83	Professional	26	$27.54	$44.67	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $251.19	Professional	TC	$58.88	$91.20	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $83.18 / $117.49	Professional		$69.18	$83.18	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.90 / $56.23	Professional	26	$25.12	$30.90	$56.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $53.70 / $95.50	Professional	TC	$25.12	$53.70	$95.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $125.89 / $257.04	Professional		$50.12	$125.89	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $245.47	Professional		$89.13	$144.54	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $43.65 / $69.18	Professional	26	$25.12	$43.65	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $95.50 / $165.96	Professional	TC	$58.88	$95.50	$165.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $128.82 / $177.83	Professional		$123.03	$128.82	$177.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $52.48	Professional	26	$36.31	$38.02	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $91.20 / $125.89	Professional	TC	$87.10	$91.20	$125.89
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $234.42	Professional		$95.50	$112.20	$234.42
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.11 / $70.79	Professional	26	$28.18	$33.11	$70.79
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $81.28 / $173.78	Professional	TC	$67.61	$81.28	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $208.93	Professional		$79.43	$114.82	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $34.67 / $61.66	Professional	26	$23.99	$34.67	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $147.91	Professional	TC	$53.70	$79.43	$147.91