Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.35 / $122.83 / $207.40	Professional		$96.35	$122.83	$207.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.38 / $63.62 / $236.73	Professional	26	$44.38	$63.62	$236.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $71.73 / $113.48	Professional	TC	$51.97	$71.73	$113.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $110.98 / $110.98 / $110.98	Professional	26	$110.98	$110.98	$110.98
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $74.63 / $151.09 / $525.00	Professional		$74.63	$151.09	$525.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $136.69 / $136.69 / $136.69	Professional	26	$136.69	$136.69	$136.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.40 / $124.16 / $248.84	Professional		$76.40	$124.16	$248.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.86 / $71.43 / $127.36	Professional	26	$36.86	$71.43	$127.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.34 / $73.78 / $148.18	Professional	TC	$38.34	$73.78	$148.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $127.05 / $176.04 / $256.86	Professional		$127.05	$176.04	$256.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.77 / $69.67 / $97.15	Professional	26	$48.77	$69.67	$97.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.28 / $123.23 / $159.72	Professional	TC	$78.28	$123.23	$159.72
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.18 / $125.68 / $209.50	Professional		$84.18	$125.68	$209.50
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.91 / $68.63 / $125.66	Professional	26	$47.91	$68.63	$125.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.92 / $69.31 / $148.55	Professional	TC	$58.92	$69.31	$148.55
United Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $127.93 / $220.29	Professional		$67.02	$127.93	$220.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.33 / $63.22 / $100.64	Professional	26	$32.33	$63.22	$100.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.24 / $72.23 / $123.79	Professional	TC	$43.24	$72.23	$123.79