Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.70 / $119.71 / $167.59	Facility	26	$119.70	$119.71	$167.59
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $57.68 / $98.48 / $317.80	Facility	53	$57.68	$98.48	$317.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.68 / $330.43 / $509.07	Professional		$233.68	$330.43	$509.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.24 / $115.00 / $228.92	Professional	26	$99.24	$115.00	$228.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.44 / $86.44 / $86.44	Professional	26	$86.44	$86.44	$86.44
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $113.43 / $198.00	Professional		$112.90	$113.43	$198.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $124.07 / $229.59 / $290.69	Professional	26	$124.07	$229.59	$290.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.56 / $385.74 / $827.00	Professional		$246.56	$385.74	$827.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.58 / $148.44 / $301.01	Professional	26	$102.58	$148.44	$301.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $262.80 / $350.38 / $720.07	Professional		$262.80	$350.38	$720.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.67 / $150.60 / $308.72	Professional	26	$112.67	$150.60	$308.72
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.74 / $231.13 / $418.75	Professional		$164.74	$231.13	$418.75
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.51 / $101.78 / $228.25	Professional	26	$86.51	$101.78	$228.25
United Facility/Professional Professional Modifier Low / Median / High Price $225.56 / $307.10 / $574.91	Professional		$225.56	$307.10	$574.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.66 / $127.23 / $245.96	Professional	26	$92.66	$127.23	$245.96