Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $363.08 / $758.58	Facility	26	$102.33	$363.08	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $363.08 / $1,047.13	Professional		$186.21	$363.08	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $102.33 / $165.96	Professional	26	$63.10	$102.33	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $190.55 / $416.87	Professional	TC	$120.23	$190.55	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $69.18	Professional	26	$67.61	$67.61	$69.18
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $309.03 / $524.81	Professional		$181.97	$309.03	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $95.50 / $162.18	Professional	26	$54.95	$95.50	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $199.53 / $363.08	Professional	TC	$123.03	$199.53	$363.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $2,344.23	Professional		$257.04	$309.03	$2,344.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $100.00 / $2,344.23	Professional	26	$85.11	$100.00	$2,344.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $208.93 / $2,344.23	Professional	TC	$173.78	$208.93	$2,344.23
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $257.04 / $426.58	Professional		$208.93	$257.04	$426.58
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $131.83	Professional	26	$66.07	$77.62	$131.83
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $177.83 / $295.12	Professional	TC	$151.36	$177.83	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $354.81 / $1,000.00	Professional		$190.55	$354.81	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $83.18 / $151.36	Professional	26	$58.88	$83.18	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $234.42 / $891.25	Professional	TC	$128.82	$234.42	$891.25