Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.91 / $28.91 / $138.91	Facility	26	$28.91	$28.91	$138.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.29 / $128.32 / $235.85	Professional		$95.29	$128.32	$235.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $31.78 / $57.93	Professional	26	$24.87	$31.78	$57.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.54 / $90.66 / $144.37	Professional	TC	$61.54	$90.66	$144.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $176.56 / $178.75	Professional		$165.00	$176.56	$178.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $34.02 / $64.79	Professional	26	$24.70	$34.02	$64.79
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $158.19 / $204.07 / $365.32	Professional		$158.19	$204.07	$365.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.66 / $167.87 / $346.07	Professional		$106.66	$167.87	$346.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.19 / $42.98 / $71.13	Professional	26	$23.19	$42.98	$71.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.38 / $115.10 / $233.41	Professional	TC	$68.38	$115.10	$233.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $143.84 / $197.74 / $337.50	Professional		$143.84	$197.74	$337.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.71 / $42.36 / $219.43	Professional	26	$34.71	$42.36	$219.43
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.55 / $155.38 / $265.30	Professional	TC	$127.55	$155.38	$265.30
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.79 / $141.91 / $196.02	Professional		$108.79	$141.91	$196.02
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.72 / $32.20 / $155.69	Professional	26	$26.72	$32.20	$155.69
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.91 / $110.48 / $173.91	Professional	TC	$93.91	$110.48	$173.91
United Facility/Professional Professional Modifier Low / Median / High Price $100.20 / $160.41 / $307.56	Professional		$100.20	$160.41	$307.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.43 / $36.15 / $61.07	Professional	26	$23.43	$36.15	$61.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.63 / $129.84 / $234.57	Professional	TC	$82.63	$129.84	$234.57