Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.10 / $27.11 / $148.96	Facility	26	$27.10	$27.11	$148.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.70 / $300.52 / $462.98	Professional		$225.70	$300.52	$462.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.15 / $31.27 / $42.54	Professional	26	$24.15	$31.27	$42.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.58 / $270.12 / $397.55	Professional	TC	$202.58	$270.12	$397.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $26.49 / $32.38	Professional	26	$23.42	$26.49	$32.38
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $61.96 / $61.96	Professional		$61.96	$61.96	$61.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.26 / $415.47 / $705.27	Professional		$240.26	$415.47	$705.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.84 / $43.17 / $71.28	Professional	26	$24.84	$43.17	$71.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.74 / $371.30 / $640.14	Professional	TC	$209.74	$371.30	$640.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $408.59 / $408.59 / $408.59	Professional		$408.59	$408.59	$408.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.35 / $45.35 / $45.35	Professional	26	$45.35	$45.35	$45.35
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.24 / $363.24 / $363.24	Professional	TC	$363.24	$363.24	$363.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.98 / $330.56 / $482.05	Professional		$280.98	$330.56	$482.05
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.96 / $34.07 / $49.57	Professional	26	$28.96	$34.07	$49.57
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.03 / $296.50 / $369.57	Professional	TC	$252.03	$296.50	$369.57
United Facility/Professional Professional Modifier Low / Median / High Price $282.17 / $395.53 / $673.15	Professional		$282.17	$395.53	$673.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.37 / $68.95	Professional	26	$30.90	$42.37	$68.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.03 / $347.31 / $605.37	Professional	TC	$250.03	$347.31	$605.37