Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $263.03 / $1,174.90	Facility	26	$162.18	$263.03	$1,174.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $1,737.80	Professional		$588.84	$812.83	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $177.83 / $549.54	Professional	26	$114.82	$177.83	$549.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $190.55 / $218.78 / $380.19	Professional	52	$190.55	$218.78	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $645.65 / $1,258.93	Professional	TC	$467.74	$645.65	$1,258.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $588.84 / $660.69	Professional		$549.54	$588.84	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $117.49 / $213.80	Professional	26	$109.65	$117.49	$213.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $457.09 / $467.74	Professional	TC	$457.09	$457.09	$467.74
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $602.56	Professional		$162.18	$181.97	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $1,023.29 / $1,862.09	Professional		$537.03	$1,023.29	$1,862.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $194.98 / $323.59	Professional	26	$104.71	$194.98	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $831.76 / $1,479.11	Professional	TC	$446.68	$831.76	$1,479.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,096.48 / $1,445.44	Professional		$512.86	$1,096.48	$1,445.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $199.53 / $245.47	Professional	26	$186.21	$199.53	$245.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $912.01 / $1,000.00 / $1,202.26	Professional	TC	$912.01	$1,000.00	$1,202.26
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $1,659.59	Professional		$537.03	$676.08	$1,659.59
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $125.89 / $302.00	Professional	26	$97.72	$125.89	$302.00
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $549.54 / $1,348.96	Professional	TC	$436.52	$549.54	$1,348.96
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $758.58 / $1,348.96	Professional		$524.81	$758.58	$1,348.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $138.04 / $263.03	Professional	26	$91.20	$138.04	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $616.60 / $1,096.48	Professional	TC	$436.52	$616.60	$1,096.48