Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.63 / $86.00 / $184.46	Professional		$56.63	$86.00	$184.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $24.48 / $109.99	Professional	26	$17.82	$24.48	$109.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.02 / $75.72 / $159.31	Professional	TC	$45.02	$75.72	$159.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.49 / $62.49 / $103.35	Professional		$62.49	$62.49	$103.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $24.49 / $24.49	Professional	26	$24.49	$24.49	$24.49
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $28.13 / $104.31 / $202.82	Professional		$28.13	$104.31	$202.82
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $51.62 / $51.62 / $51.68	Professional	26	$51.62	$51.62	$51.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $90.17 / $177.93	Professional		$50.79	$90.17	$177.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.03 / $27.30 / $48.54	Professional	26	$14.03	$27.30	$48.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.39 / $64.79 / $131.44	Professional	TC	$39.39	$64.79	$131.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $118.96 / $168.83	Professional		$83.27	$118.96	$168.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $28.81 / $37.04	Professional	26	$18.59	$28.81	$37.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.69 / $92.41 / $131.79	Professional	TC	$64.69	$92.41	$131.79
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.93 / $101.33 / $158.81	Professional		$70.93	$101.33	$158.81
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.94 / $22.22 / $71.87	Professional	26	$17.94	$22.22	$71.87
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.17 / $78.59 / $120.36	Professional	TC	$56.17	$78.59	$120.36
United Facility/Professional Professional Modifier Low / Median / High Price $46.99 / $75.31 / $132.13	Professional		$46.99	$75.31	$132.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $22.93 / $37.70	Professional	26	$12.32	$22.93	$37.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.38 / $66.34 / $117.26	Professional	TC	$39.38	$66.34	$117.26