Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $100.00 / $467.74	Facility	26	$63.10	$100.00	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $2,089.30	Professional		$323.59	$537.03	$2,089.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $263.03	Professional	26	$67.61	$89.13	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $416.87 / $1,122.02	Professional	TC	$269.15	$416.87	$1,122.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $562.34	Professional		$302.00	$371.54	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $107.15	Professional	26	$57.54	$72.44	$107.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $309.03	Professional	TC	$257.04	$257.04	$309.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $549.54	Professional		$81.28	$134.90	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $588.84 / $1,071.52	Professional		$346.74	$588.84	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $93.33 / $158.49	Professional	26	$53.70	$93.33	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $467.74 / $831.76	Professional	TC	$269.15	$467.74	$831.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Professional	26	$102.33	$102.33	$102.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $512.86 / $512.86	Professional	TC	$512.86	$512.86	$512.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $489.78 / $851.14	Professional		$416.87	$489.78	$851.14
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $141.25	Professional	26	$64.57	$75.86	$141.25
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $416.87 / $724.44	Professional	TC	$354.81	$416.87	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $588.84 / $1,023.29	Professional		$407.38	$588.84	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $158.49	Professional	26	$67.61	$95.50	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $489.78 / $851.14	Professional	TC	$338.84	$489.78	$851.14