Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $36.31 / $63.10	Facility	26	$10.23	$36.31	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $34.67 / $100.00	Professional		$24.55	$34.67	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.12 / $25.12	Professional	26	$6.03	$9.12	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $58.88	Professional	TC	$16.60	$23.99	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $22.39 / $31.62	Professional		$19.50	$22.39	$31.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.76 / $8.91	Professional	26	$6.17	$7.76	$8.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	TC	$25.12	$25.12	$25.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $5.75 / $5.75	Facility	26	$5.75	$5.75	$5.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.90 / $63.10	Professional		$25.12	$38.90	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.72 / $17.78	Professional	26	$6.46	$10.72	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.18 / $45.71	Professional	TC	$17.78	$28.18	$45.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $45.71 / $63.10	Professional		$38.90	$45.71	$63.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.48 / $15.49	Professional	26	$9.77	$11.48	$15.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $47.86	Professional	TC	$28.84	$34.67	$47.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.62 / $63.10	Professional		$26.92	$31.62	$63.10
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.51 / $18.62	Professional	26	$7.24	$8.51	$18.62
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $22.91 / $48.98	Professional	TC	$19.50	$22.91	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $57.54	Professional		$22.91	$33.11	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.12 / $15.85	Professional	26	$6.03	$9.12	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $43.65	Professional	TC	$16.60	$23.99	$43.65