Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $43.66 / $237.56	Facility	26	$43.65	$43.66	$237.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.66 / $330.02 / $401.12	Professional		$242.66	$330.02	$401.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.40 / $50.41 / $61.04	Professional	26	$38.40	$50.41	$61.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $205.63 / $277.86 / $347.92	Professional	TC	$205.63	$277.86	$347.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.68 / $42.68 / $42.68	Professional	26	$42.68	$42.68	$42.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.86 / $446.88 / $769.65	Professional		$258.86	$446.88	$769.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $69.42 / $114.40	Professional	26	$39.97	$69.42	$114.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $211.79 / $375.00 / $658.77	Professional	TC	$211.79	$375.00	$658.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $440.64 / $440.64 / $440.64	Professional		$440.64	$440.64	$440.64
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.66 / $72.66 / $72.66	Professional	26	$72.66	$72.66	$72.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $367.98 / $367.98 / $367.98	Professional	TC	$367.98	$367.98	$367.98
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.98 / $355.27 / $521.04	Professional		$301.98	$355.27	$521.04
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.64 / $54.87 / $67.86	Professional	26	$46.64	$54.87	$67.86
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $255.34 / $300.39 / $449.12	Professional	TC	$255.34	$300.39	$449.12
United Facility/Professional Professional Modifier Low / Median / High Price $308.38 / $438.28 / $722.51	Professional		$308.38	$438.28	$722.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $64.91 / $111.10	Professional	26	$47.93	$64.91	$111.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.80 / $366.38 / $613.35	Professional	TC	$253.80	$366.38	$613.35