Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.83 / $6.84 / $34.40	Facility	26	$6.83	$6.84	$34.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.57 / $30.33 / $58.91	Professional		$21.57	$30.33	$58.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $8.13 / $14.20	Professional	26	$6.37	$8.13	$14.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.24 / $59.24 / $176.15	Professional	50	$59.24	$59.24	$176.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $21.20 / $30.39	Professional	TC	$15.29	$21.20	$30.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.72 / $22.72 / $22.72	Professional		$22.72	$22.72	$22.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $10.52 / $16.51	Professional	26	$10.11	$10.52	$16.51
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.76 / $55.25 / $55.25	Professional		$15.76	$55.25	$55.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.76 / $5.76 / $5.76	Facility	26	$5.76	$5.76	$5.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.34 / $35.44 / $57.00	Professional		$23.34	$35.44	$57.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $10.37 / $17.00	Professional	26	$6.25	$10.37	$17.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.18 / $23.78 / $40.97	Professional	TC	$16.18	$23.78	$40.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $43.56 / $62.87	Professional		$33.22	$43.56	$62.87
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.85 / $11.48 / $15.74	Professional	26	$9.85	$11.48	$15.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.79 / $34.54 / $47.14	Professional	TC	$28.79	$34.54	$47.14
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.37 / $31.58 / $45.20	Professional		$26.37	$31.58	$45.20
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $7.93 / $23.32	Professional	26	$6.74	$7.93	$23.32
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $23.46 / $32.93	Professional	TC	$18.98	$23.46	$32.93
United Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $32.74 / $56.32	Professional		$21.52	$32.74	$56.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $9.17 / $15.42	Professional	26	$6.21	$9.17	$15.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $25.01 / $42.50	Professional	TC	$16.42	$25.01	$42.50