Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.63 / $32.63 / $110.15	Facility	26	$32.63	$32.63	$110.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.97 / $411.84 / $635.44	Professional		$295.97	$411.84	$635.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $37.78 / $53.78	Professional	26	$29.14	$37.78	$53.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.83 / $375.03 / $534.92	Professional	TC	$266.83	$375.03	$534.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $286.87 / $286.87 / $286.87	Professional		$286.87	$286.87	$286.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $34.47 / $50.67	Professional	26	$31.67	$34.47	$50.67
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $114.75 / $114.75 / $114.75	Professional		$114.75	$114.75	$114.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $322.14 / $563.76 / $961.93	Professional		$322.14	$563.76	$961.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.81 / $52.42 / $87.07	Professional	26	$29.81	$52.42	$87.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.63 / $505.96 / $879.10	Professional	TC	$285.63	$505.96	$879.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $548.99 / $548.99 / $548.99	Professional		$548.99	$548.99	$548.99
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $55.08 / $55.08	Professional	26	$55.08	$55.08	$55.08
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $493.91 / $493.91 / $493.91	Professional	TC	$493.91	$493.91	$493.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $379.79 / $446.81 / $576.29	Professional		$379.79	$446.81	$576.29
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.67 / $41.97 / $66.75	Professional	26	$35.67	$41.97	$66.75
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $344.11 / $404.84 / $589.51	Professional	TC	$344.11	$404.84	$589.51
United Facility/Professional Professional Modifier Low / Median / High Price $384.22 / $544.38 / $910.12	Professional		$384.22	$544.38	$910.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $51.87 / $87.08	Professional	26	$37.04	$51.87	$87.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $345.48 / $496.97 / $826.62	Professional	TC	$345.48	$496.97	$826.62