Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $269.15 / $489.78	Facility	26	$69.18	$269.15	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $776.25	Professional		$213.80	$331.13	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $223.87	Professional	26	$52.48	$66.07	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $269.15 / $575.44	Professional	TC	$173.78	$269.15	$575.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	26	$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $416.87 / $758.58	Professional		$251.19	$416.87	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $79.43 / $134.90	Professional	26	$45.71	$79.43	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $323.59 / $575.44	Professional	TC	$186.21	$323.59	$575.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	26	$85.11	$85.11	$85.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	TC	$363.08	$363.08	$363.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $616.60	Professional		$302.00	$354.81	$616.60
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $120.23	Professional	26	$54.95	$64.57	$120.23
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $288.40 / $501.19	Professional	TC	$245.47	$288.40	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $416.87 / $707.95	Professional		$295.12	$416.87	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $134.90	Professional	26	$57.54	$81.28	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $331.13 / $588.84	Professional	TC	$229.09	$331.13	$588.84