Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $75.86 / $346.74	Facility	26	$48.98	$75.86	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $537.03	Professional		$144.54	$181.97	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $63.10 / $223.87	Professional	26	$46.77	$63.10	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $120.23 / $302.00	Professional	TC	$93.33	$120.23	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $51.29 / $61.66	Professional	26	$41.69	$51.29	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $239.88 / $371.54	Professional		$144.54	$239.88	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $69.18 / $117.49	Professional	26	$40.74	$69.18	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $165.96 / $288.40	Professional	TC	$102.33	$165.96	$288.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	TC	$169.82	$169.82	$169.82
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $181.97 / $331.13	Professional		$154.88	$181.97	$331.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $56.23 / $104.71	Professional	26	$47.86	$56.23	$104.71
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $125.89 / $229.09	Professional	TC	$107.15	$125.89	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $371.54	Professional		$154.88	$213.80	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $114.82	Professional	26	$46.77	$67.61	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $147.91 / $257.04	Professional	TC	$104.71	$147.91	$257.04