Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $95.50 / $380.19	Facility	26	$58.88	$95.50	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $223.87 / $977.24	Professional		$114.82	$223.87	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $141.25 / $851.14	Professional	26	$57.54	$141.25	$851.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $100.00 / $275.42	Professional	TC	$57.54	$100.00	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $95.50 / $120.23	Professional		$93.33	$95.50	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $54.95 / $60.26	Professional	26	$47.86	$54.95	$60.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	TC	$87.10	$87.10	$87.10
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $141.25 / $346.74	Professional		$64.57	$141.25	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $331.13	Professional		$112.20	$190.55	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $131.83	Professional	26	$51.29	$74.13	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $117.49 / $194.98	Professional	TC	$60.26	$117.49	$194.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $177.83	Professional		$151.36	$169.82	$177.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $83.18	Professional	26	$70.79	$79.43	$83.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $91.20 / $95.50	Professional	TC	$79.43	$91.20	$95.50
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $295.12	Professional		$109.65	$147.91	$295.12
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $67.61 / $125.89	Professional	26	$50.12	$67.61	$125.89
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $79.43 / $181.97	Professional	TC	$58.88	$79.43	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $275.42	Professional		$100.00	$154.88	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $69.18 / $123.03	Professional	26	$45.71	$69.18	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $85.11 / $158.49	Professional	TC	$52.48	$85.11	$158.49