Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.85 / $33.86 / $100.65	Facility	26	$33.85	$33.86	$100.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.23 / $237.37 / $353.69	Professional		$171.23	$237.37	$353.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $34.46 / $57.32	Professional	26	$30.35	$34.46	$57.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.88 / $202.66 / $309.10	Professional	TC	$140.88	$202.66	$309.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.45 / $190.45 / $190.45	Professional		$190.45	$190.45	$190.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $62.62 / $64.42	Professional	26	$29.89	$62.62	$64.42
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $40.34 / $110.50 / $329.43	Professional		$40.34	$110.50	$329.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.55 / $317.08 / $577.17	Professional		$181.55	$317.08	$577.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.71 / $44.66 / $79.92	Professional	26	$30.71	$44.66	$79.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.50 / $272.25 / $501.47	Professional	TC	$148.50	$272.25	$501.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $315.19 / $377.66 / $377.66	Professional		$315.19	$377.66	$377.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.15 / $50.33 / $50.33	Professional	26	$43.15	$50.33	$50.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.04 / $327.33 / $327.33	Professional	TC	$272.04	$327.33	$327.33
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.34 / $289.81 / $426.88	Professional		$246.34	$289.81	$426.88
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.28 / $36.57 / $322.37	Professional	26	$30.28	$36.57	$322.37
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.78 / $253.25 / $393.65	Professional	TC	$204.78	$253.25	$393.65
United Facility/Professional Professional Modifier Low / Median / High Price $154.78 / $287.44 / $563.92	Professional		$154.78	$287.44	$563.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $38.53 / $71.15	Professional	26	$26.94	$38.53	$71.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.94 / $269.14 / $492.79	Professional	TC	$160.94	$269.14	$492.79