Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.30 / $66.28 / $92.79	Facility	26	$50.30	$66.28	$92.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.47 / $219.25 / $614.25	Professional		$135.47	$219.25	$614.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $56.90 / $119.39	Professional	26	$35.11	$56.90	$119.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.37 / $159.04 / $250.91	Professional	TC	$99.37	$159.04	$250.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.79 / $117.25 / $133.99	Professional		$95.79	$117.25	$133.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.82 / $35.64 / $77.81	Professional	26	$28.82	$35.64	$77.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $166.20 / $293.64	Professional		$40.65	$166.20	$293.64
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $64.79 / $105.28	Professional	26	$36.79	$64.79	$105.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.12 / $259.08 / $473.64	Professional		$155.12	$259.08	$473.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.91 / $61.62 / $109.00	Professional	26	$31.91	$61.62	$109.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.44 / $180.46 / $356.72	Professional	TC	$116.44	$180.46	$356.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $169.29 / $224.78 / $463.85	Professional		$169.29	$224.78	$463.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $54.09 / $112.07	Professional	26	$40.90	$54.09	$112.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.38 / $170.69 / $351.79	Professional	TC	$128.38	$170.69	$351.79
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.80 / $151.63 / $283.62	Professional		$119.80	$151.63	$283.62
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.98 / $36.45 / $173.79	Professional	26	$30.98	$36.45	$173.79
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.10 / $110.71 / $270.37	Professional	TC	$94.10	$110.71	$270.37
United Facility/Professional Professional Modifier Low / Median / High Price $124.16 / $186.15 / $368.98	Professional		$124.16	$186.15	$368.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.90 / $46.11 / $85.70	Professional	26	$28.90	$46.11	$85.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.37 / $149.18 / $269.70	Professional	TC	$100.37	$149.18	$269.70