Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $562.34 / $2,691.53	Facility	26	$380.19	$562.34	$2,691.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,290.87 / $9,549.93	Professional		$1,621.81	$2,290.87	$9,549.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $512.86 / $1,445.44	Professional	26	$371.54	$512.86	$1,445.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.93 / $1,862.09 / $3,981.07	Professional	TC	$1,258.93	$1,862.09	$3,981.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $2,089.30	Professional		$1,380.38	$1,479.11	$2,089.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $380.19 / $616.60	Professional	26	$338.84	$380.19	$616.60
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,905.46 / $4,466.84	Professional		$446.68	$1,905.46	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,454.71 / $4,365.16	Professional		$1,548.82	$2,454.71	$4,365.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $501.19 / $912.01	Professional	26	$354.81	$501.19	$912.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,949.84 / $3,548.13	Professional	TC	$1,202.26	$1,949.84	$3,548.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,691.53 / $2,818.38	Professional		$2,344.23	$2,691.53	$2,818.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $489.78 / $562.34 / $575.44	Professional	26	$489.78	$562.34	$575.44
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,862.09 / $2,089.30 / $2,238.72	Professional	TC	$1,862.09	$2,089.30	$2,238.72
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,290.87 / $4,073.80	Professional		$1,698.24	$2,290.87	$4,073.80
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $346.74 / $467.74 / $933.25	Professional	26	$346.74	$467.74	$933.25
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,819.70 / $3,311.31	Professional	TC	$1,318.26	$1,819.70	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,187.76 / $3,981.07	Professional		$1,479.11	$2,187.76	$3,981.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $467.74 / $831.76	Professional	26	$309.03	$467.74	$831.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,174.90 / $1,737.80 / $3,311.31	Professional	TC	$1,174.90	$1,737.80	$3,311.31