Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.96 / $48.97 / $48.97	Facility	26	$48.96	$48.97	$48.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.22 / $76.42 / $128.88	Professional		$54.22	$76.42	$128.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.94 / $46.47 / $68.17	Professional	26	$35.94	$46.47	$68.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $27.45 / $49.13	Professional	TC	$18.28	$27.45	$49.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.94 / $85.94 / $85.94	Professional		$85.94	$85.94	$85.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $101.04 / $207.95	Professional		$71.20	$101.04	$207.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.27 / $59.61 / $128.76	Professional	26	$40.27	$59.61	$128.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.84 / $43.97 / $83.45	Professional	TC	$25.84	$43.97	$83.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $117.74 / $242.30	Professional		$88.43	$117.74	$242.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.95 / $58.59 / $120.42	Professional	26	$43.95	$58.59	$120.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.48 / $59.14 / $121.88	Professional	TC	$44.48	$59.14	$121.88
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $54.12 / $92.85	Professional		$34.04	$54.12	$92.85
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $42.84 / $75.14	Professional	26	$33.21	$42.84	$75.14
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.04 / $30.95 / $55.28	Professional	TC	$25.04	$30.95	$55.28
United Facility/Professional Professional Modifier Low / Median / High Price $55.52 / $75.61 / $141.69	Professional		$55.52	$75.61	$141.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.46 / $46.52 / $90.56	Professional	26	$29.46	$46.52	$90.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $31.60 / $61.33	Professional	TC	$20.70	$31.60	$61.33