Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.39 / $318.20 / $920.66	Facility		$123.39	$318.20	$920.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.12 / $24.13 / $40.54	Facility	26	$24.12	$24.13	$40.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.89 / $129.78 / $223.79	Professional		$107.89	$129.78	$223.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $22.93 / $40.54	Professional	26	$20.50	$22.93	$40.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.29 / $105.45 / $175.65	Professional	TC	$86.29	$105.45	$175.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.96 / $21.96 / $21.96	Professional	26	$21.96	$21.96	$21.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.05 / $233.58 / $444.26	Facility		$231.05	$233.58	$444.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.40 / $191.01 / $357.29	Professional		$114.40	$191.01	$357.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $30.06 / $56.12	Professional	26	$19.47	$30.06	$56.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.16 / $152.49 / $283.94	Professional	TC	$90.16	$152.49	$283.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $178.43 / $369.60	Professional		$134.88	$178.43	$369.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $33.13 / $70.56	Professional	26	$25.75	$33.13	$70.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.14 / $145.30 / $299.04	Professional	TC	$109.14	$145.30	$299.04
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $249.00 / $258.52 / $493.06	Facility		$249.00	$258.52	$493.06
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.90 / $125.52 / $239.77	Professional		$96.90	$125.52	$239.77
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.98 / $22.34 / $147.66	Professional	26	$18.98	$22.34	$147.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $96.81 / $170.37	Professional	TC	$82.29	$96.81	$170.37
United Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $137.35 / $263.36	Professional		$91.77	$137.35	$263.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $25.92 / $47.49	Professional	26	$16.86	$25.92	$47.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.63 / $114.73 / $222.86	Professional	TC	$77.63	$114.73	$222.86