Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.45 / $105.78 / $242.06	Professional		$73.45	$105.78	$242.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $44.44 / $128.07	Professional	26	$31.25	$44.44	$128.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.21 / $63.39 / $100.42	Professional	TC	$42.21	$63.39	$100.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.14 / $66.14 / $66.14	Professional		$66.14	$66.14	$66.14
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $84.80 / $122.08 / $192.00	Professional		$84.80	$122.08	$192.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $101.64 / $101.64 / $101.64	Professional	26	$101.64	$101.64	$101.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.12 / $121.27 / $219.39	Professional		$65.12	$121.27	$219.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $48.47 / $96.97	Professional	26	$23.93	$48.47	$96.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.82 / $61.81 / $123.73	Professional	TC	$39.82	$61.81	$123.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.32 / $126.17 / $178.46	Professional		$88.32	$126.17	$178.46
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $41.33 / $57.56	Professional	26	$28.93	$41.33	$57.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.39 / $84.84 / $120.89	Professional	TC	$59.39	$84.84	$120.89
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.87 / $102.89 / $187.40	Professional		$83.87	$102.89	$187.40
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.48 / $38.99 / $133.88	Professional	26	$28.48	$38.99	$133.88
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.97 / $71.27 / $148.68	Professional	TC	$58.97	$71.27	$148.68
United Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $103.69 / $171.32	Professional		$58.61	$103.69	$171.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $37.43 / $61.64	Professional	26	$19.14	$37.43	$61.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.45 / $66.17 / $116.72	Professional	TC	$36.45	$66.17	$116.72