Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.93 / $50.94 / $80.20	Facility	26	$50.93	$50.94	$80.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.81 / $248.01 / $411.75	Professional		$195.81	$248.01	$411.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $48.09 / $80.20	Professional	26	$41.17	$48.09	$80.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.80 / $199.92 / $336.29	Professional	TC	$151.80	$199.92	$336.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $287.69 / $287.69 / $287.69	Professional		$287.69	$287.69	$287.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $92.80 / $92.80 / $92.80	Professional	26	$92.80	$92.80	$92.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.96 / $409.58 / $806.82	Professional		$250.96	$409.58	$806.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $61.67 / $119.29	Professional	26	$38.67	$61.67	$119.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $211.06 / $315.41 / $671.76	Professional	TC	$211.06	$315.41	$671.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $295.79 / $394.14 / $810.46	Professional		$295.79	$394.14	$810.46
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.00 / $65.03 / $134.26	Professional	26	$49.00	$65.03	$134.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $246.78 / $329.09 / $676.18	Professional	TC	$246.78	$329.09	$676.18
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.45 / $280.50 / $429.90	Professional		$229.45	$280.50	$429.90
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.17 / $46.58 / $277.32	Professional	26	$37.17	$46.58	$277.32
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.93 / $226.21 / $396.87	Professional	TC	$182.93	$226.21	$396.87
United Facility/Professional Professional Modifier Low / Median / High Price $196.92 / $288.94 / $557.05	Professional		$196.92	$288.94	$557.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $50.17 / $93.03	Professional	26	$34.54	$50.17	$93.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.41 / $259.27 / $542.04	Professional	TC	$168.41	$259.27	$542.04