Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.58 / $337.46 / $509.63	Professional		$282.58	$337.46	$509.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.17 / $125.45 / $346.80	Professional	26	$79.17	$125.45	$346.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $214.20 / $342.02	Professional	TC	$181.94	$214.20	$342.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $237.60 / $237.60 / $237.60	Professional	26	$237.60	$237.60	$237.60
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $180.70 / $197.98 / $368.90	Professional		$180.70	$197.98	$368.90
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $283.33 / $283.33 / $283.33	Professional	26	$283.33	$283.33	$283.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.60 / $305.58 / $690.56	Professional		$165.60	$305.58	$690.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.73 / $147.38 / $266.41	Professional	26	$73.73	$147.38	$266.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.28 / $184.86 / $520.16	Professional	TC	$99.28	$184.86	$520.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $318.04 / $411.00 / $643.13	Professional		$318.04	$411.00	$643.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.02 / $144.32 / $201.34	Professional	26	$101.02	$144.32	$201.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $217.01 / $310.02 / $441.79	Professional	TC	$217.01	$310.02	$441.79
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.61 / $354.26 / $616.14	Professional		$281.61	$354.26	$616.14
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.12 / $122.54 / $375.65	Professional	26	$99.12	$122.54	$375.65
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.56 / $258.64 / $616.14	Professional	TC	$194.56	$258.64	$616.14
United Facility/Professional Professional Modifier Low / Median / High Price $168.35 / $348.10 / $571.94	Professional		$168.35	$348.10	$571.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.03 / $137.38 / $208.23	Professional	26	$67.03	$137.38	$208.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.63 / $224.62 / $393.74	Professional	TC	$122.63	$224.62	$393.74