Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.02 / $219.02 / $606.03	Facility	26	$219.02	$219.02	$606.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $432.97 / $554.91 / $795.75	Professional		$432.97	$554.91	$795.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $188.96 / $219.02 / $353.95	Professional	26	$188.96	$219.02	$353.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.02 / $316.77 / $489.17	Professional	TC	$225.02	$316.77	$489.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $180.26 / $236.05 / $377.21	Professional	26	$180.26	$236.05	$377.21
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $237.90 / $632.40 / $1,035.00	Professional		$237.90	$632.40	$1,035.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $195.77 / $372.21 / $539.70	Professional	26	$195.77	$372.21	$539.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.01 / $738.56 / $1,445.01	Professional		$427.01	$738.56	$1,445.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $187.01 / $277.39 / $487.93	Professional	26	$187.01	$277.39	$487.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.02 / $449.81 / $1,169.63	Professional	TC	$235.02	$449.81	$1,169.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $566.39 / $671.29 / $671.29	Professional		$566.39	$671.29	$671.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $259.82 / $303.01 / $303.01	Professional	26	$259.82	$303.01	$303.01
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $306.57 / $368.28 / $368.28	Professional	TC	$306.57	$368.28	$368.28
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.88 / $466.64 / $820.29	Professional		$371.88	$466.64	$820.29
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $182.15 / $219.95 / $378.09	Professional	26	$182.15	$219.95	$378.09
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $222.05 / $274.55 / $509.22	Professional	TC	$222.05	$274.55	$509.22
United Facility/Professional Professional Modifier Low / Median / High Price $378.92 / $655.16 / $1,174.63	Professional		$378.92	$655.16	$1,174.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $170.51 / $260.60 / $448.65	Professional	26	$170.51	$260.60	$448.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $214.39 / $360.35 / $720.52	Professional	TC	$214.39	$360.35	$720.52