Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $252.77 / $550.66 / $2,100.01	Facility		$252.77	$550.66	$2,100.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.75 / $37.75 / $52.84	Facility	26	$37.75	$37.75	$52.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $183.36 / $449.23 / $802.40	Facility	TC	$183.36	$449.23	$802.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.56 / $208.90 / $416.92	Professional		$172.56	$208.90	$416.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $35.70 / $87.37	Professional	26	$30.50	$35.70	$87.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.25 / $169.96 / $303.64	Professional	TC	$138.25	$169.96	$303.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.35 / $161.22 / $206.86	Professional		$109.35	$161.22	$206.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $29.54 / $68.02	Professional	26	$24.64	$29.54	$68.02
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $718.04 / $1,975.84 / $6,766.20	Facility		$718.04	$1,975.84	$6,766.20
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $206.70 / $493.32	Professional		$35.04	$206.70	$493.32
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $37.09 / $56.35 / $97.80	Professional	26	$37.09	$56.35	$97.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $327.68 / $381.66 / $725.85	Facility		$327.68	$381.66	$725.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.28 / $292.76 / $556.84	Professional		$181.28	$292.76	$556.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $44.68 / $87.90	Professional	26	$28.02	$44.68	$87.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.87 / $238.76 / $453.28	Professional	TC	$148.87	$238.76	$453.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $213.43 / $283.37 / $971.29	Professional		$213.43	$283.37	$971.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $46.20 / $971.29	Professional	26	$35.36	$46.20	$971.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.08 / $237.16 / $971.29	Professional	TC	$178.08	$237.16	$971.29
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $474.24 / $538.58 / $587.66	Facility		$474.24	$538.58	$587.66
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.87 / $208.25 / $348.42	Professional		$163.87	$208.25	$348.42
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $32.22 / $259.73	Professional	26	$26.74	$32.22	$259.73
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.47 / $161.33 / $291.56	Professional	TC	$130.47	$161.33	$291.56
United Facility/Professional Professional Modifier Low / Median / High Price $139.38 / $214.03 / $405.46	Professional		$139.38	$214.03	$405.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $37.07 / $71.94	Professional	26	$25.08	$37.07	$71.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.12 / $189.09 / $354.36	Professional	TC	$122.12	$189.09	$354.36