Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.58 / $119.21 / $518.49	Facility	26	$101.58	$119.21	$518.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.10 / $371.89 / $655.39	Professional		$189.10	$371.89	$655.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.13 / $111.15 / $140.00	Professional	26	$64.13	$111.15	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.74 / $259.35 / $335.00	Professional	TC	$122.74	$259.35	$335.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.38 / $144.26 / $158.94	Professional		$132.38	$144.26	$158.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.06 / $62.06 / $70.73	Professional	26	$62.06	$62.06	$70.73
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $603.75 / $603.75 / $603.75	Professional		$603.75	$603.75	$603.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.32 / $302.87 / $518.66	Professional		$179.32	$302.87	$518.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.85 / $95.60 / $160.12	Professional	26	$54.85	$95.60	$160.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.24 / $207.38 / $362.12	Professional	TC	$124.24	$207.38	$362.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $258.80 / $317.25 / $581.34	Professional		$258.80	$317.25	$581.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.78 / $99.24 / $170.82	Professional	26	$84.78	$99.24	$170.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.27 / $208.39 / $282.56	Professional	TC	$173.27	$208.39	$282.56
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.49 / $246.00 / $418.83	Professional		$206.49	$246.00	$418.83
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.84 / $75.09 / $111.31	Professional	26	$63.84	$75.09	$111.31
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.27 / $170.90 / $228.88	Professional	TC	$145.27	$170.90	$228.88
United Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $357.71 / $949.74	Professional		$193.25	$357.71	$949.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.48 / $82.81 / $144.65	Professional	26	$60.48	$82.81	$144.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.12 / $225.66 / $832.11	Professional	TC	$132.12	$225.66	$832.11