Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.45 / $51.45 / $77.06	Facility	26	$51.45	$51.45	$77.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.71 / $151.72 / $247.48	Professional		$114.71	$151.72	$247.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $48.17 / $77.06	Professional	26	$38.26	$48.17	$77.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.44 / $106.60 / $168.76	Professional	TC	$76.44	$106.60	$168.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.62 / $100.62 / $135.97	Professional		$100.62	$100.62	$135.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.17 / $34.17 / $34.17	Professional	26	$34.17	$34.17	$34.17
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $47.27 / $47.27 / $47.27	Professional		$47.27	$47.27	$47.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.96 / $206.89 / $385.52	Professional		$140.96	$206.89	$385.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.64 / $62.14 / $120.28	Professional	26	$42.64	$62.14	$120.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.56 / $148.85 / $285.88	Professional	TC	$98.56	$148.85	$285.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.34 / $192.50 / $422.89	Professional		$154.34	$192.50	$422.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.36 / $61.90 / $971.29	Professional	26	$46.36	$61.90	$971.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.98 / $143.74 / $971.29	Professional	TC	$107.98	$143.74	$971.29
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.98 / $133.63 / $244.51	Professional		$82.98	$133.63	$244.51
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.78 / $41.92 / $154.29	Professional	26	$34.78	$41.92	$154.29
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.95 / $113.62 / $191.92	Professional	TC	$78.95	$113.62	$191.92
United Facility/Professional Professional Modifier Low / Median / High Price $129.60 / $192.95 / $327.88	Professional		$129.60	$192.95	$327.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.07 / $52.19 / $101.29	Professional	26	$39.07	$52.19	$101.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.43 / $131.18 / $234.50	Professional	TC	$88.43	$131.18	$234.50