Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.46 / $28.46 / $41.18	Facility	26	$28.46	$28.46	$41.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.41 / $186.63 / $349.11	Professional		$147.41	$186.63	$349.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.80 / $24.69 / $41.18	Professional	26	$21.80	$24.69	$41.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.45 / $159.66 / $303.14	Professional	TC	$124.45	$159.66	$303.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.72 / $178.72 / $178.72	Professional		$178.72	$178.72	$178.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.29 / $255.57 / $492.01	Professional		$154.29	$255.57	$492.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $32.84 / $61.80	Professional	26	$20.43	$32.84	$61.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.71 / $218.12 / $384.90	Professional	TC	$130.71	$218.12	$384.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $184.81 / $244.85 / $506.38	Professional		$184.81	$244.85	$506.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.14 / $33.65 / $71.62	Professional	26	$26.14	$33.65	$71.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.66 / $211.20 / $434.76	Professional	TC	$158.66	$211.20	$434.76
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.71 / $185.05 / $328.50	Professional		$137.71	$185.05	$328.50
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.42 / $81.15	Professional	26	$19.05	$22.42	$81.15
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.65 / $139.59 / $252.27	Professional	TC	$118.65	$139.59	$252.27
United Facility/Professional Professional Modifier Low / Median / High Price $132.01 / $186.44 / $345.62	Professional		$132.01	$186.44	$345.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.63 / $47.22	Professional	26	$18.20	$25.63	$47.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.93 / $168.18 / $321.80	Professional	TC	$103.93	$168.18	$321.80