Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $204.17 / $977.24	Facility	26	$141.25	$204.17	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $741.31	Professional		$245.47	$302.00	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $181.97 / $446.68	Professional	26	$128.82	$181.97	$446.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $144.54 / $346.74	Professional	TC	$112.20	$144.54	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $309.03	Professional		$234.42	$234.42	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $269.15	Professional	26	$123.03	$123.03	$269.15
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Professional		$162.18	$162.18	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $363.08 / $660.69	Professional		$239.88	$363.08	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $186.21 / $331.13	Professional	26	$125.89	$186.21	$331.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $173.78 / $331.13	Professional	TC	$112.20	$173.78	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $389.05 / $407.38	Professional		$346.74	$389.05	$407.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $204.17 / $208.93	Professional	26	$177.83	$204.17	$208.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $190.55 / $199.53	Professional	TC	$165.96	$190.55	$199.53
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $575.44	Professional		$204.17	$251.19	$575.44
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $141.25 / $302.00	Professional	26	$109.65	$141.25	$302.00
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $123.03 / $295.12	Professional	TC	$104.71	$123.03	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $588.84	Professional		$218.78	$323.59	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $165.96 / $302.00	Professional	26	$112.20	$165.96	$302.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $158.49 / $288.40	Professional	TC	$107.15	$158.49	$288.40