Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.25 / $44.26 / $209.99	Facility	26	$44.25	$44.26	$209.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.08 / $349.19 / $408.41	Professional		$260.08	$349.19	$408.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $48.31 / $62.19	Professional	26	$34.13	$48.31	$62.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.96 / $301.16 / $355.51	Professional	TC	$225.96	$301.16	$355.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.24 / $38.24 / $38.24	Professional	26	$38.24	$38.24	$38.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.81 / $436.02 / $697.39	Professional		$275.81	$436.02	$697.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.04 / $61.66 / $103.66	Professional	26	$35.04	$61.66	$103.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.84 / $366.75 / $595.29	Professional	TC	$228.84	$366.75	$595.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $475.30 / $475.30 / $475.30	Professional		$475.30	$475.30	$475.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.15 / $65.15 / $65.15	Professional	26	$65.15	$65.15	$65.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $410.15 / $410.15 / $410.15	Professional	TC	$410.15	$410.15	$410.15
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.49 / $391.17 / $504.19	Professional		$332.49	$391.17	$504.19
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.80 / $49.18 / $64.34	Professional	26	$41.80	$49.18	$64.34
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $290.69 / $341.99 / $452.99	Professional	TC	$290.69	$341.99	$452.99
United Facility/Professional Professional Modifier Low / Median / High Price $285.56 / $445.99 / $762.51	Professional		$285.56	$445.99	$762.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.70 / $59.15 / $99.05	Professional	26	$44.70	$59.15	$99.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.46 / $393.08 / $660.35	Professional	TC	$255.46	$393.08	$660.35