Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.95 / $78.84 / $195.76	Facility	26	$74.95	$78.84	$195.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $409.29 / $515.30 / $752.15	Professional		$409.29	$515.30	$752.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $75.54 / $129.74	Professional	26	$67.73	$75.54	$129.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $322.43 / $440.35 / $621.46	Professional	TC	$322.43	$440.35	$621.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.63 / $85.96 / $137.36	Professional	26	$65.63	$85.96	$137.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $131.30 / $568.74	Professional		$86.54	$131.30	$568.74
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $71.22 / $135.56 / $197.66	Professional	26	$71.22	$135.56	$197.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.31 / $615.51 / $1,191.55	Professional		$364.31	$615.51	$1,191.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $99.37 / $176.69	Professional	26	$68.48	$99.37	$176.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $300.68 / $511.80 / $1,004.59	Professional	TC	$300.68	$511.80	$1,004.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $517.44 / $619.14 / $619.14	Professional		$517.44	$619.14	$619.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.61 / $110.38 / $110.38	Professional	26	$94.61	$110.38	$110.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $422.82 / $508.78 / $508.78	Professional	TC	$422.82	$508.78	$508.78
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $440.61 / $518.37 / $758.95	Professional		$440.61	$518.37	$758.95
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.76 / $80.62 / $579.24	Professional	26	$66.76	$80.62	$579.24
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $353.97 / $437.75 / $722.31	Professional	TC	$353.97	$437.75	$722.31
United Facility/Professional Professional Modifier Low / Median / High Price $311.77 / $546.66 / $1,008.68	Professional		$311.77	$546.66	$1,008.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.79 / $93.69 / $161.83	Professional	26	$59.79	$93.69	$161.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.64 / $478.66 / $851.80	Professional	TC	$286.64	$478.66	$851.80