Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.53 / $100.53 / $435.08	Facility	26	$100.53	$100.53	$435.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.92 / $179.81 / $263.76	Professional		$123.92	$179.81	$263.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.90 / $100.53 / $162.47	Professional	26	$88.90	$100.53	$162.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.65 / $67.28 / $163.22	Professional	TC	$28.65	$67.28	$163.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.72 / $108.72 / $113.46	Professional		$108.72	$108.72	$113.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.48 / $111.94 / $178.91	Professional	26	$85.48	$111.94	$178.91
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $827.25 / $827.25 / $827.25	Professional		$827.25	$827.25	$827.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $239.85 / $581.51	Professional		$118.41	$239.85	$581.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.95 / $133.71 / $234.23	Professional	26	$89.95	$133.71	$234.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.09 / $73.09 / $434.19	Professional	TC	$27.09	$73.09	$434.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $169.40 / $199.08 / $199.08	Professional		$169.40	$199.08	$199.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.24 / $143.75 / $143.75	Professional	26	$123.24	$143.75	$143.75
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.16 / $55.33 / $55.33	Professional	TC	$46.16	$55.33	$55.33
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $127.63 / $327.02	Professional		$40.17	$127.63	$327.02
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.78 / $104.78 / $167.08	Professional	26	$86.78	$104.78	$167.08
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $26.82 / $59.27	Professional	TC	$22.80	$26.82	$59.27
United Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $191.49 / $467.92	Professional		$112.22	$191.49	$467.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.43 / $122.39 / $211.85	Professional	26	$78.43	$122.39	$211.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.89 / $41.19 / $167.04	Professional	TC	$24.89	$41.19	$167.04