Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $147.91	Professional		$93.33	$117.49	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $18.20	Professional	26	$12.02	$14.13	$18.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $102.33 / $128.82	Professional	TC	$79.43	$102.33	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $269.15	Professional		$85.11	$138.04	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.98 / $28.84	Professional	26	$12.30	$16.98	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $120.23 / $239.88	Professional	TC	$72.44	$120.23	$239.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $213.80	Professional		$162.18	$165.96	$213.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $17.38 / $21.88	Professional	26	$16.98	$17.38	$21.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $151.36 / $190.55	Professional	TC	$144.54	$151.36	$190.55
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $213.80	Professional		$97.72	$125.89	$213.80
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $27.54	Professional	26	$12.02	$15.14	$27.54
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $104.71 / $173.78	Professional	TC	$83.18	$104.71	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $154.88	Professional		$67.61	$100.00	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.18 / $20.42	Professional	26	$9.33	$13.18	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $138.04	Professional	TC	$58.88	$91.20	$138.04