Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.90 / $57.91 / $81.06	Facility	26	$57.90	$57.91	$81.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.58 / $360.94 / $531.59	Professional		$273.58	$360.94	$531.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.26 / $57.34 / $87.22	Professional	26	$46.26	$57.34	$87.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.50 / $302.63 / $438.61	Professional	TC	$224.50	$302.63	$438.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $332.09 / $346.98 / $436.38	Professional		$332.09	$346.98	$436.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $55.69 / $71.89	Professional	26	$50.67	$55.69	$71.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $98.79 / $493.11 / $1,287.22	Professional		$98.79	$493.11	$1,287.22
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $52.00 / $74.65 / $202.30	Professional	26	$52.00	$74.65	$202.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.20 / $60.20 / $60.20	Facility	26	$60.20	$60.20	$60.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.96 / $476.21 / $954.82	Professional		$243.96	$476.21	$954.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $76.95 / $140.88	Professional	26	$41.49	$76.95	$140.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.46 / $405.11 / $814.37	Professional	TC	$198.46	$405.11	$814.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $457.80 / $597.84 / $775.32	Professional		$457.80	$597.84	$775.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.70 / $80.80 / $104.91	Professional	26	$62.70	$80.80	$104.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $395.10 / $517.04 / $670.43	Professional	TC	$395.10	$517.04	$670.43
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.69 / $361.88 / $603.54	Professional		$293.69	$361.88	$603.54
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.23 / $53.41 / $360.93	Professional	26	$44.23	$53.41	$360.93
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $249.46 / $308.48 / $515.86	Professional	TC	$249.46	$308.48	$515.86
United Facility/Professional Professional Modifier Low / Median / High Price $192.12 / $416.29 / $815.03	Professional		$192.12	$416.29	$815.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.70 / $62.82 / $111.00	Professional	26	$40.70	$62.82	$111.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.16 / $341.36 / $640.04	Professional	TC	$225.16	$341.36	$640.04