Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.89 / $225.65 / $357.78	Professional		$178.89	$225.65	$357.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.08 / $79.84 / $278.49	Professional	26	$46.08	$79.84	$278.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.18 / $153.21 / $240.14	Professional	TC	$131.18	$153.21	$240.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.08 / $160.08 / $160.08	Professional		$160.08	$160.08	$160.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $88.37 / $108.49 / $134.66	Professional	26	$88.37	$108.49	$134.66
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $112.30 / $221.00 / $442.50	Professional		$112.30	$221.00	$442.50
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $84.16 / $160.28 / $195.17	Professional	26	$84.16	$160.28	$195.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.53 / $207.13 / $456.02	Professional		$114.53	$207.13	$456.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.30 / $84.24 / $148.00	Professional	26	$43.30	$84.24	$148.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.48 / $130.13 / $370.46	Professional	TC	$72.48	$130.13	$370.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $213.47 / $304.95 / $432.36	Professional		$213.47	$304.95	$432.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.30 / $82.02 / $145.65	Professional	26	$57.30	$82.02	$145.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $156.16 / $223.09 / $318.06	Professional	TC	$156.16	$223.09	$318.06
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.89 / $257.98 / $443.75	Professional		$185.89	$257.98	$443.75
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $74.73 / $257.62	Professional	26	$56.22	$74.73	$257.62
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.84 / $188.74 / $443.75	Professional	TC	$137.84	$188.74	$443.75
United Facility/Professional Professional Modifier Low / Median / High Price $112.98 / $217.07 / $384.19	Professional		$112.98	$217.07	$384.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $70.06 / $118.12	Professional	26	$37.85	$70.06	$118.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.55 / $165.20 / $283.20	Professional	TC	$93.55	$165.20	$283.20