Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.39 / $100.59 / $140.82	Facility	26	$73.39	$100.59	$140.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.78 / $284.14 / $579.64	Professional		$235.78	$284.14	$579.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $84.79 / $243.53	Professional	26	$51.50	$84.79	$243.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.63 / $196.93 / $346.82	Professional	TC	$151.63	$196.93	$346.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.24 / $193.41 / $247.76	Professional		$169.24	$193.41	$247.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $47.23 / $100.53	Professional	26	$40.04	$47.23	$100.53
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $98.19 / $320.05 / $633.75	Professional		$98.19	$320.05	$633.75
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $57.00 / $96.76 / $310.14	Professional	26	$57.00	$96.76	$310.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.80 / $442.75 / $818.34	Professional		$257.80	$442.75	$818.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.11 / $91.86 / $158.31	Professional	26	$47.11	$91.86	$158.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.02 / $320.95 / $636.39	Professional	TC	$203.02	$320.95	$636.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $300.85 / $399.33 / $824.33	Professional		$300.85	$399.33	$824.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.66 / $78.09 / $163.47	Professional	26	$59.66	$78.09	$163.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $241.19 / $321.24 / $660.86	Professional	TC	$241.19	$321.24	$660.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.11 / $279.79 / $458.85	Professional		$222.11	$279.79	$458.85
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.55 / $52.41 / $329.26	Professional	26	$44.55	$52.41	$329.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.55 / $220.79 / $388.49	Professional	TC	$178.55	$220.79	$388.49
United Facility/Professional Professional Modifier Low / Median / High Price $213.35 / $323.10 / $625.07	Professional		$213.35	$323.10	$625.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.38 / $66.19 / $130.07	Professional	26	$42.38	$66.19	$130.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.63 / $253.09 / $505.15	Professional	TC	$171.63	$253.09	$505.15