Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $114.82 / $398.11	Facility	26	$56.23	$114.82	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $446.68	Professional		$125.89	$162.18	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.48 / $173.78	Professional	26	$39.81	$52.48	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $112.20 / $263.03	Professional	TC	$83.18	$112.20	$263.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $54.95 / $63.10	Professional	26	$52.48	$54.95	$63.10
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $354.81	Professional		$141.25	$204.17	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $60.26 / $102.33	Professional	26	$43.65	$60.26	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $144.54 / $257.04	Professional	TC	$97.72	$144.54	$257.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $234.42	Professional		$162.18	$190.55	$234.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $53.70 / $85.11	Professional	26	$47.86	$53.70	$85.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $120.23 / $190.55	Professional	TC	$112.20	$120.23	$190.55
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $141.25 / $302.00	Professional		$83.18	$141.25	$302.00
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $42.66 / $107.15	Professional	26	$35.48	$42.66	$107.15
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $114.82 / $223.87	Professional	TC	$89.13	$114.82	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $295.12	Professional		$125.89	$173.78	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $50.12 / $89.13	Professional	26	$38.90	$50.12	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $120.23 / $213.80	Professional	TC	$87.10	$120.23	$213.80