Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.32 / $47.32 / $230.61	Facility	26	$47.32	$47.32	$230.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.25 / $163.03 / $277.23	Professional		$128.25	$163.03	$277.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.32 / $65.34 / $106.31	Professional	26	$47.32	$65.34	$106.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.28 / $97.60 / $160.22	Professional	TC	$67.28	$97.60	$160.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.40 / $95.50 / $95.50	Professional		$76.40	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.35 / $64.81 / $127.94	Professional	26	$48.35	$64.81	$127.94
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $123.78 / $243.00	Professional		$75.28	$123.78	$243.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.48 / $195.43 / $401.06	Professional		$105.48	$195.43	$401.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.91 / $76.58 / $136.09	Professional	26	$47.91	$76.58	$136.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.66 / $113.57 / $306.77	Professional	TC	$55.66	$113.57	$306.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.02 / $172.06 / $561.60	Professional		$128.02	$172.06	$561.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.65 / $86.56 / $101.89	Professional	26	$67.65	$86.56	$101.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.51 / $74.86 / $90.70	Professional	TC	$58.51	$74.86	$90.70
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $128.84 / $232.25	Professional		$71.20	$128.84	$232.25
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.92 / $69.31 / $120.81	Professional	26	$58.92	$69.31	$120.81
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.54 / $80.63 / $152.58	Professional	TC	$68.54	$80.63	$152.58
United Facility/Professional Professional Modifier Low / Median / High Price $103.45 / $182.94 / $321.64	Professional		$103.45	$182.94	$321.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.61 / $75.59 / $132.27	Professional	26	$47.61	$75.59	$132.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.88 / $94.47 / $177.48	Professional	TC	$47.88	$94.47	$177.48