Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $56.23 / $263.03	Facility	26	$32.36	$56.23	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $1,202.26	Professional		$338.84	$457.09	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $53.70 / $114.82	Professional	26	$32.36	$53.70	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $398.11 / $870.96	Professional	TC	$302.00	$398.11	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $37.15 / $45.71	Professional	26	$33.11	$37.15	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $309.03 / $309.03	Professional	TC	$309.03	$309.03	$309.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $575.44 / $1,000.00	Professional		$331.13	$575.44	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $52.48 / $89.13	Professional	26	$29.51	$52.48	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $512.86 / $912.01	Professional	TC	$302.00	$512.86	$912.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	26	$56.23	$56.23	$56.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $489.78 / $489.78	Professional	TC	$489.78	$489.78	$489.78
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $467.74 / $776.25	Professional		$398.11	$467.74	$776.25
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $42.66 / $75.86	Professional	26	$36.31	$42.66	$75.86
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $426.58 / $707.95	Professional	TC	$363.08	$426.58	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $537.03 / $912.01	Professional		$371.54	$537.03	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $87.10	Professional	26	$33.88	$50.12	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $489.78 / $831.76	Professional	TC	$338.84	$489.78	$831.76