Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.10 / $17.11 / $30.34	Facility	26	$17.10	$17.11	$30.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $134.10 / $237.17	Professional		$109.93	$134.10	$237.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $21.80 / $39.38	Professional	26	$14.49	$21.80	$39.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.02 / $112.49 / $192.90	Professional	TC	$92.02	$112.49	$192.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $86.46 / $90.62	Professional		$72.50	$86.46	$90.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $18.38 / $48.79	Professional	26	$16.78	$18.38	$48.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $195.60 / $374.19	Professional		$120.06	$195.60	$374.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.77 / $26.73 / $53.26	Professional	26	$16.77	$26.73	$53.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.89 / $159.97 / $310.95	Professional	TC	$96.89	$159.97	$310.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.26 / $187.32 / $387.05	Professional		$141.26	$187.32	$387.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.13 / $32.67 / $68.86	Professional	26	$25.13	$32.67	$68.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $116.13 / $154.65 / $318.20	Professional	TC	$116.13	$154.65	$318.20
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.01 / $135.34 / $241.09	Professional		$108.01	$135.34	$241.09
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $22.42 / $135.69	Professional	26	$18.64	$22.42	$135.69
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.64 / $104.65 / $196.34	Professional	TC	$84.64	$104.65	$196.34
United Facility/Professional Professional Modifier Low / Median / High Price $96.35 / $136.15 / $262.08	Professional		$96.35	$136.15	$262.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $25.26 / $45.64	Professional	26	$15.01	$25.26	$45.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.62 / $126.12 / $253.16	Professional	TC	$82.62	$126.12	$253.16