Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $405.15 / $466.05 / $726.18	Professional		$405.15	$466.05	$726.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.92 / $44.66 / $67.38	Professional	26	$35.92	$44.66	$67.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $351.96 / $413.46 / $658.80	Professional	TC	$351.96	$413.46	$658.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.67 / $315.67 / $315.67	Professional		$315.67	$315.67	$315.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $285.77 / $285.77 / $285.77	Professional	TC	$285.77	$285.77	$285.77
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $628.39 / $642.98 / $1,351.24	Professional		$628.39	$642.98	$1,351.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.20 / $582.09 / $1,008.14	Professional		$365.20	$582.09	$1,008.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $54.82 / $102.99	Professional	26	$32.39	$54.82	$102.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $333.41 / $524.19 / $903.89	Professional	TC	$333.41	$524.19	$903.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $418.52 / $545.14 / $849.65	Professional		$418.52	$545.14	$849.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.77 / $63.15 / $106.11	Professional	26	$40.77	$63.15	$106.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $377.76 / $539.65 / $768.46	Professional	TC	$377.76	$539.65	$768.46
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $413.34 / $588.91 / $1,013.46	Professional		$413.34	$588.91	$1,013.46
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $53.18 / $614.58	Professional	26	$38.84	$53.18	$614.58
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $374.50 / $497.87 / $808.12	Professional	TC	$374.50	$497.87	$808.12
United Facility/Professional Professional Modifier Low / Median / High Price $270.36 / $480.86 / $825.08	Professional		$270.36	$480.86	$825.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.04 / $41.32 / $71.75	Professional	26	$26.04	$41.32	$71.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.21 / $449.71 / $770.35	Professional	TC	$242.21	$449.71	$770.35