Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $371.54 / $549.54	Facility	26	$74.13	$371.54	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.23 / $331.13	Professional		$91.20	$120.23	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $177.83	Professional	26	$54.95	$70.79	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $87.10	Professional	TC	$28.18	$44.67	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $117.49	Professional		$107.15	$107.15	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	26	$66.07	$66.07	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $323.59	Professional		$95.50	$134.90	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $89.13 / $194.98	Professional	26	$58.88	$89.13	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $51.29 / $117.49	Professional	TC	$32.36	$51.29	$117.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $218.78	Professional		$120.23	$158.49	$218.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $89.13 / $125.89	Professional	26	$66.07	$89.13	$125.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $93.33	Professional	TC	$53.70	$72.44	$93.33
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $97.72 / $218.78	Professional		$50.12	$97.72	$218.78
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $154.88	Professional	26	$52.48	$72.44	$154.88
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $38.90 / $81.28	Professional	TC	$30.90	$38.90	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $194.98	Professional		$75.86	$102.33	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $128.82	Professional	26	$44.67	$67.61	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $38.90 / $72.44	Professional	TC	$26.30	$38.90	$72.44