Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $302.00 / $1,445.44	Facility	26	$218.78	$302.00	$1,445.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $524.81 / $1,174.90	Professional		$407.38	$524.81	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $275.42 / $758.58	Professional	26	$199.53	$275.42	$758.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $288.40 / $630.96	Professional	TC	$213.80	$288.40	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $371.54 / $512.86	Professional		$346.74	$371.54	$512.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $204.17 / $331.13	Professional	26	$173.78	$204.17	$331.13
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $776.25 / $1,659.59	Professional		$239.88	$776.25	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $616.60 / $1,096.48	Professional		$398.11	$616.60	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $275.42 / $489.78	Professional	26	$186.21	$275.42	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $331.13 / $616.60	Professional	TC	$199.53	$331.13	$616.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $676.08	Professional		$562.34	$645.65	$676.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $302.00 / $309.03	Professional	26	$263.03	$302.00	$309.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $338.84 / $363.08	Professional	TC	$302.00	$338.84	$363.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $977.24	Professional		$416.87	$562.34	$977.24
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $251.19 / $446.68	Professional	26	$186.21	$251.19	$446.68
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $316.23 / $562.34	Professional	TC	$234.42	$316.23	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $549.54 / $1,000.00	Professional		$371.54	$549.54	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $245.47 / $457.09	Professional	26	$169.82	$245.47	$457.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $302.00 / $549.54	Professional	TC	$199.53	$302.00	$549.54