Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $144.54 / $537.03	Facility	26	$102.33	$144.54	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $1,000.00	Professional		$229.09	$338.84	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $120.23 / $363.08	Professional	26	$77.62	$120.23	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $181.97 / $398.11	Professional	TC	$138.04	$181.97	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $208.93 / $380.19	Professional		$194.98	$208.93	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $138.04	Professional	26	$77.62	$97.72	$138.04
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $346.74 / $588.84	Professional		$234.42	$346.74	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $117.49 / $194.98	Professional	26	$81.28	$117.49	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $213.80 / $398.11	Professional	TC	$154.88	$213.80	$398.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $295.12 / $467.74	Professional		$275.42	$295.12	$467.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $100.00 / $158.49	Professional	26	$91.20	$100.00	$158.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $194.98 / $309.03	Professional	TC	$181.97	$194.98	$309.03
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $602.56	Professional		$194.98	$234.42	$602.56
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $204.17	Professional	26	$67.61	$79.43	$204.17
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $154.88 / $426.58	Professional	TC	$128.82	$154.88	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $489.78	Professional		$213.80	$281.84	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $95.50 / $169.82	Professional	26	$74.13	$95.50	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $181.97 / $323.59	Professional	TC	$138.04	$181.97	$323.59