Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.01 / $84.22 / $84.22	Facility	26	$77.01	$84.22	$84.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.47 / $151.40 / $232.81	Professional		$87.47	$151.40	$232.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.13 / $56.27 / $84.22	Professional	26	$41.13	$56.27	$84.22
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.71 / $72.93 / $116.41	Professional	52	$42.71	$72.93	$116.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.29 / $95.13 / $151.75	Professional	TC	$44.29	$95.13	$151.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.31 / $98.31 / $98.31	Professional		$98.31	$98.31	$98.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $56.90 / $79.66	Professional	26	$40.94	$56.90	$79.66
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $54.60 / $65.70	Professional		$54.60	$54.60	$65.70
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $38.86 / $174.14	Professional	26	$38.86	$38.86	$174.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.90 / $84.90 / $84.90	Facility	26	$84.90	$84.90	$84.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.43 / $215.86 / $397.76	Professional		$70.43	$215.86	$397.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $80.22 / $150.15	Professional	26	$32.20	$80.22	$150.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $138.26 / $258.01	Professional	TC	$38.22	$138.26	$258.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.70 / $144.82 / $188.36	Professional		$111.70	$144.82	$188.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.39 / $62.36 / $80.79	Professional	26	$48.39	$62.36	$80.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.30 / $82.46 / $107.57	Professional	TC	$63.30	$82.46	$107.57
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $108.84 / $218.96	Professional		$77.42	$108.84	$218.96
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $41.37 / $104.52	Professional	26	$34.34	$41.37	$104.52
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.17 / $71.94 / $183.69	Professional	TC	$58.17	$71.94	$183.69
United Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $169.44 / $331.58	Professional		$80.34	$169.44	$331.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.08 / $52.33 / $113.34	Professional	26	$32.08	$52.33	$113.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.38 / $91.00 / $181.64	Professional	TC	$40.38	$91.00	$181.64