Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $33.54 / $50.55	Facility	26	$33.53	$33.54	$50.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.14 / $209.86 / $454.62	Professional		$172.14	$209.86	$454.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $36.65 / $68.42	Professional	26	$28.30	$36.65	$68.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.35 / $169.96 / $301.10	Professional	TC	$136.35	$169.96	$301.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.78 / $167.88 / $190.49	Professional		$121.78	$167.88	$190.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $31.67 / $53.68	Professional	26	$27.64	$31.67	$53.68
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $65.79 / $249.11 / $506.54	Professional		$65.79	$249.11	$506.54
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $58.03 / $99.12	Professional	26	$40.74	$58.03	$99.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.35 / $296.41 / $567.79	Professional		$184.35	$296.41	$567.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.97 / $45.17 / $86.82	Professional	26	$29.97	$45.17	$86.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.93 / $241.61 / $479.94	Professional	TC	$147.93	$241.61	$479.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $171.45 / $219.98 / $593.80	Professional		$171.45	$219.98	$593.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.36 / $53.96 / $831.06	Professional	26	$41.36	$53.96	$831.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.36 / $233.53 / $831.06	Professional	TC	$175.36	$233.53	$831.06
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.44 / $207.34 / $344.15	Professional		$167.44	$207.34	$344.15
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.91 / $36.36 / $236.16	Professional	26	$30.91	$36.36	$236.16
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.53 / $160.62 / $289.20	Professional	TC	$136.53	$160.62	$289.20
United Facility/Professional Professional Modifier Low / Median / High Price $153.60 / $212.58 / $397.67	Professional		$153.60	$212.58	$397.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.02 / $42.82 / $72.95	Professional	26	$26.02	$42.82	$72.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.77 / $195.17 / $367.49	Professional	TC	$124.77	$195.17	$367.49