Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.42 / $18.42 / $100.20	Facility	26	$18.42	$18.42	$100.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $221.90 / $271.56	Professional		$164.42	$221.90	$271.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $21.21 / $28.18	Professional	26	$16.04	$21.21	$28.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.83 / $201.29 / $249.19	Professional	TC	$148.83	$201.29	$249.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.52 / $157.52 / $157.52	Professional		$157.52	$157.52	$157.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $17.82 / $17.82	Professional	26	$17.82	$17.82	$17.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $41.73 / $41.73 / $84.00	Professional		$41.73	$41.73	$84.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.21 / $302.06 / $518.91	Professional		$176.21	$302.06	$518.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $29.21 / $48.68	Professional	26	$16.91	$29.21	$48.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.37 / $272.51 / $472.16	Professional	TC	$155.37	$272.51	$472.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $301.24 / $301.24 / $301.24	Professional		$301.24	$301.24	$301.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $30.40 / $30.40	Professional	26	$30.40	$30.40	$30.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $270.83 / $270.83 / $270.83	Professional	TC	$270.83	$270.83	$270.83
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.55 / $241.82 / $362.65	Professional		$205.55	$241.82	$362.65
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $22.81 / $33.68	Professional	26	$19.39	$22.81	$33.68
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.16 / $219.01 / $328.46	Professional	TC	$186.16	$219.01	$328.46
United Facility/Professional Professional Modifier Low / Median / High Price $210.41 / $294.62 / $492.50	Professional		$210.41	$294.62	$492.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $25.95 / $45.36	Professional	26	$19.66	$25.95	$45.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.45 / $267.20 / $447.14	Professional	TC	$186.45	$267.20	$447.14