Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.76 / $97.95 / $270.89	Facility		$60.76	$97.95	$270.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.90 / $20.90 / $52.82	Facility	26	$20.90	$20.90	$52.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.47 / $79.34 / $125.52	Professional		$45.47	$79.34	$125.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.71 / $31.46 / $60.58	Professional	26	$21.71	$31.46	$60.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.53 / $326.11 / $334.86	Professional	50	$56.53	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.00 / $30.38 / $49.81	Professional	52	$21.00	$30.38	$49.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $52.74 / $79.62	Professional	TC	$16.60	$52.74	$79.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $33.40 / $33.40	Professional	26	$33.40	$33.40	$33.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $103.12 / $188.53	Professional		$37.14	$103.12	$188.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $38.74 / $68.97	Professional	26	$21.30	$38.74	$68.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.83 / $62.02 / $124.14	Professional	TC	$14.83	$62.02	$124.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $70.53 / $127.32	Professional		$52.83	$70.53	$127.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.42 / $43.58 / $78.13	Professional	26	$32.42	$43.58	$78.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $26.95 / $49.19	Professional	TC	$20.41	$26.95	$49.19
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.90 / $287.22 / $636.45	Facility		$252.90	$287.22	$636.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $59.31 / $108.08	Professional		$38.13	$59.31	$108.08
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $29.65 / $52.32	Professional	26	$24.50	$29.65	$52.32
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.93 / $32.04 / $82.49	Professional	TC	$25.93	$32.04	$82.49
United Facility/Professional Professional Modifier Low / Median / High Price $31.13 / $63.52 / $123.69	Professional		$31.13	$63.52	$123.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $32.19 / $53.49	Professional	26	$16.97	$32.19	$53.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.74 / $37.36 / $87.68	Professional	TC	$11.74	$37.36	$87.68