Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.10 / $41.10 / $203.28	Facility	26	$41.10	$41.10	$203.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.47 / $299.49 / $374.13	Professional		$235.47	$299.49	$374.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.77 / $45.98 / $53.87	Professional	26	$32.77	$45.98	$53.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.75 / $253.39 / $317.45	Professional	TC	$203.75	$253.39	$317.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.03 / $229.03 / $229.03	Professional		$229.03	$229.03	$229.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.43 / $36.43 / $36.43	Professional	26	$36.43	$36.43	$36.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.20 / $396.17 / $670.50	Professional		$244.20	$396.17	$670.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.38 / $58.62 / $100.17	Professional	26	$33.38	$58.62	$100.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.01 / $340.83 / $583.08	Professional	TC	$189.01	$340.83	$583.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $435.74 / $435.74 / $435.74	Professional		$435.74	$435.74	$435.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.14 / $62.14 / $62.14	Professional	26	$62.14	$62.14	$62.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $373.60 / $373.60 / $373.60	Professional	TC	$373.60	$373.60	$373.60
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.12 / $348.38 / $443.94	Professional		$296.12	$348.38	$443.94
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.19 / $47.28 / $70.90	Professional	26	$40.19	$47.28	$70.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $255.95 / $301.12 / $424.27	Professional	TC	$255.95	$301.12	$424.27
United Facility/Professional Professional Modifier Low / Median / High Price $259.20 / $397.46 / $711.48	Professional		$259.20	$397.46	$711.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.30 / $56.78 / $94.50	Professional	26	$41.30	$56.78	$94.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.09 / $336.64 / $602.98	Professional	TC	$248.09	$336.64	$602.98