Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.67 / $38.67 / $213.36	Facility	26	$38.67	$38.67	$213.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.51 / $306.20 / $441.77	Professional		$227.51	$306.20	$441.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.27 / $47.14 / $63.64	Professional	26	$36.27	$47.14	$63.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.15 / $256.39 / $373.36	Professional	TC	$194.15	$256.39	$373.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $37.96 / $43.34	Professional	26	$37.96	$37.96	$43.34
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $88.18 / $88.90	Professional		$52.91	$88.18	$88.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.84 / $415.78 / $707.35	Professional		$236.84	$415.78	$707.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $61.89 / $103.51	Professional	26	$35.36	$61.89	$103.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.48 / $354.88 / $607.29	Professional	TC	$201.48	$354.88	$607.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $416.15 / $416.15 / $416.15	Professional		$416.15	$416.15	$416.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.76 / $64.76 / $64.76	Professional	26	$64.76	$64.76	$64.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $351.39 / $351.39 / $351.39	Professional	TC	$351.39	$351.39	$351.39
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.34 / $335.07 / $470.41	Professional		$255.34	$335.07	$470.41
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.85 / $49.24 / $70.70	Professional	26	$41.85	$49.24	$70.70
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.96 / $285.83 / $345.29	Professional	TC	$242.96	$285.83	$345.29
United Facility/Professional Professional Modifier Low / Median / High Price $286.76 / $385.14 / $681.55	Professional		$286.76	$385.14	$681.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.24 / $60.86 / $98.48	Professional	26	$44.24	$60.86	$98.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $241.87 / $348.25 / $587.87	Professional	TC	$241.87	$348.25	$587.87