Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.18 / $102.18 / $143.05	Facility	26	$102.18	$102.18	$143.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.81 / $273.85 / $478.87	Professional		$226.81	$273.85	$478.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.79 / $93.32 / $149.78	Professional	26	$75.79	$93.32	$149.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.53 / $176.93 / $289.44	Professional	TC	$146.53	$176.93	$289.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.65 / $255.65 / $255.65	Professional		$255.65	$255.65	$255.65
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $254.30 / $439.48 / $710.77	Professional		$254.30	$439.48	$710.77
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $116.05 / $198.22 / $295.77	Professional	26	$116.05	$198.22	$295.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.38 / $351.89 / $713.11	Professional		$236.38	$351.89	$713.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.48 / $119.93 / $231.86	Professional	26	$80.48	$119.93	$231.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.53 / $225.78 / $471.39	Professional	TC	$157.53	$225.78	$471.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $261.48 / $348.39 / $716.46	Professional		$261.48	$348.39	$716.46
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.44 / $117.00 / $239.59	Professional	26	$87.44	$117.00	$239.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $174.04 / $231.39 / $476.87	Professional	TC	$174.04	$231.39	$476.87
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.15 / $221.61 / $367.81	Professional		$184.15	$221.61	$367.81
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.70 / $79.17 / $265.19	Professional	26	$65.70	$79.17	$265.19
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.66 / $151.65 / $259.42	Professional	TC	$122.66	$151.65	$259.42
United Facility/Professional Professional Modifier Low / Median / High Price $214.34 / $288.54 / $534.91	Professional		$214.34	$288.54	$534.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.88 / $99.35 / $187.22	Professional	26	$73.88	$99.35	$187.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.81 / $183.99 / $366.49	Professional	TC	$137.81	$183.99	$366.49