Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $144.54	Professional		$87.10	$107.15	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $77.62 / $107.15	Professional	26	$67.61	$77.62	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $38.02	Professional	TC	$19.05	$30.20	$38.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $218.78	Professional		$85.11	$125.89	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $154.88	Professional	26	$64.57	$89.13	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $35.48 / $63.10	Professional	TC	$18.20	$35.48	$63.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $123.03 / $158.49	Professional		$120.23	$123.03	$158.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $112.20	Professional	26	$85.11	$87.10	$112.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $45.71	Professional	TC	$34.67	$36.31	$45.71
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $190.55	Professional		$87.10	$107.15	$190.55
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $79.43 / $147.91	Professional	26	$63.10	$79.43	$147.91
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $28.84 / $46.77	Professional	TC	$23.44	$28.84	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $144.54	Professional		$66.07	$91.20	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $107.15	Professional	26	$48.98	$69.18	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $24.55 / $38.90	Professional	TC	$16.22	$24.55	$38.90