Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.62 / $48.62 / $48.62	Facility	26	$48.62	$48.62	$48.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.39 / $137.46 / $214.00	Professional		$107.39	$137.46	$214.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $45.43 / $63.44	Professional	26	$37.65	$45.43	$63.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.18 / $90.57 / $153.26	Professional	TC	$67.18	$90.57	$153.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.44 / $130.44 / $130.44	Professional		$130.44	$130.44	$130.44
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $144.49 / $144.49 / $180.00	Professional		$144.49	$144.49	$180.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.03 / $50.03 / $50.03	Facility	26	$50.03	$50.03	$50.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.34 / $199.75 / $420.19	Professional		$99.34	$199.75	$420.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.57 / $62.00 / $113.73	Professional	26	$32.57	$62.00	$113.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.34 / $125.73 / $322.07	Professional	TC	$64.34	$125.73	$322.07
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $137.54 / $178.72 / $232.24	Professional		$137.54	$178.72	$232.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.46 / $63.59 / $82.76	Professional	26	$49.46	$63.59	$82.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.08 / $115.24 / $149.47	Professional	TC	$88.08	$115.24	$149.47
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.85 / $120.35 / $219.85	Professional		$95.85	$120.35	$219.85
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.18 / $42.43 / $110.01	Professional	26	$35.18	$42.43	$110.01
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.11 / $82.98 / $145.59	Professional	TC	$67.11	$82.98	$145.59
United Facility/Professional Professional Modifier Low / Median / High Price $91.92 / $141.91 / $287.22	Professional		$91.92	$141.91	$287.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.92 / $46.39 / $87.47	Professional	26	$31.92	$46.39	$87.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.33 / $95.12 / $190.36	Professional	TC	$58.33	$95.12	$190.36