Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $186.21 / $416.87	Facility	26	$47.86	$186.21	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $602.56	Professional		$128.82	$169.82	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $213.80	Professional	26	$54.95	$87.10	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $239.88	Professional	TC	$67.61	$100.00	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $114.82	Professional	26	$54.95	$85.11	$114.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $245.47	Professional		$75.86	$123.03	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $199.53 / $416.87	Professional		$109.65	$199.53	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $75.86 / $138.04	Professional	26	$50.12	$75.86	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $112.20 / $295.12	Professional	TC	$56.23	$112.20	$295.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $204.17	Professional		$125.89	$147.91	$204.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $109.65	Professional	26	$67.61	$79.43	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $67.61 / $95.50	Professional	TC	$57.54	$67.61	$95.50
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $147.91 / $281.84	Professional		$75.86	$147.91	$281.84
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $117.49	Professional	26	$60.26	$70.79	$117.49
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $83.18 / $162.18	Professional	TC	$69.18	$83.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $331.13	Professional		$102.33	$177.83	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $72.44 / $131.83	Professional	26	$47.86	$72.44	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $93.33 / $223.87	Professional	TC	$51.29	$93.33	$223.87