Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.59 / $45.59 / $196.70	Facility	26	$45.59	$45.59	$196.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.28 / $104.67 / $147.83	Professional		$85.28	$104.67	$147.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $45.64 / $68.92	Professional	26	$40.96	$45.64	$68.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.04 / $54.64 / $80.18	Professional	TC	$39.04	$54.64	$80.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $39.97 / $68.90	Professional	26	$39.97	$39.97	$68.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.42 / $143.62 / $252.67	Professional		$83.42	$143.62	$252.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.42 / $60.64 / $107.61	Professional	26	$41.42	$60.64	$107.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.83 / $73.14 / $172.72	Professional	TC	$40.83	$73.14	$172.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $131.10 / $131.10	Professional		$110.81	$131.10	$131.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.63 / $67.18 / $67.18	Professional	26	$57.63	$67.18	$67.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.19 / $63.91 / $63.91	Professional	TC	$53.19	$63.91	$63.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $80.86 / $211.85	Professional		$54.08	$80.86	$211.85
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $46.06 / $75.84	Professional	26	$38.15	$46.06	$75.84
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $52.74 / $88.78	Professional	TC	$36.31	$52.74	$88.78
United Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $127.03 / $221.90	Professional		$75.06	$127.03	$221.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.49 / $55.88 / $96.28	Professional	26	$36.49	$55.88	$96.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.25 / $60.22 / $111.54	Professional	TC	$36.25	$60.22	$111.54