Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.96 / $40.96 / $193.20	Facility	26	$40.96	$40.96	$193.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.11 / $223.63 / $289.24	Professional		$155.11	$223.63	$289.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.41 / $44.07 / $51.06	Professional	26	$31.41	$44.07	$51.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.95 / $176.68 / $241.47	Professional	TC	$124.95	$176.68	$241.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $34.90 / $40.44	Professional	26	$34.90	$34.90	$40.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.15 / $302.58 / $526.37	Professional		$181.15	$302.58	$526.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.45 / $56.87 / $95.13	Professional	26	$32.45	$56.87	$95.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.56 / $231.72 / $400.11	Professional	TC	$144.56	$231.72	$400.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $288.60 / $288.60 / $288.60	Professional		$288.60	$288.60	$288.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.46 / $59.46 / $59.46	Professional	26	$59.46	$59.46	$59.46
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.13 / $229.13 / $229.13	Professional	TC	$229.13	$229.13	$229.13
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.61 / $227.78 / $321.73	Professional		$193.61	$227.78	$321.73
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $45.27 / $66.19	Professional	26	$38.47	$45.27	$66.19
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.13 / $182.52 / $290.29	Professional	TC	$155.13	$182.52	$290.29
United Facility/Professional Professional Modifier Low / Median / High Price $178.50 / $272.54 / $478.78	Professional		$178.50	$272.54	$478.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $54.38 / $93.70	Professional	26	$39.95	$54.38	$93.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.28 / $231.51 / $391.09	Professional	TC	$154.28	$231.51	$391.09