Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.07 / $176.01 / $363.24	Facility		$39.07	$176.01	$363.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.39 / $9.39 / $51.81	Facility	26	$9.39	$9.39	$51.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.83 / $51.89 / $237.84	Facility	TC	$20.83	$51.89	$237.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $36.22 / $64.58	Professional		$27.79	$36.22	$64.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $10.11 / $20.45	Professional	26	$7.62	$10.11	$20.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $25.92 / $37.49	Professional	TC	$18.27	$25.92	$37.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $25.33 / $26.82	Professional		$21.46	$25.33	$26.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $8.26 / $19.78	Professional	26	$6.48	$8.26	$19.78
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $9.46 / $15.63 / $39.10	Professional		$9.46	$15.63	$39.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.40 / $82.61 / $128.25	Facility		$67.40	$82.61	$128.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.88 / $7.88 / $7.88	Facility	26	$7.88	$7.88	$7.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.73 / $16.73 / $16.73	Facility	TC	$16.73	$16.73	$16.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $43.85 / $73.01	Professional		$27.79	$43.85	$73.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $13.71 / $23.00	Professional	26	$6.41	$13.71	$23.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.70 / $31.00 / $49.73	Professional	TC	$19.70	$31.00	$49.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $50.28 / $68.64	Professional		$42.23	$50.28	$68.64
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 $32.33 / $38.79 / $52.90	Professional	TC	$32.33	$38.79	$52.90
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.52 / $258.52 / $493.06	Facility		$258.52	$258.52	$493.06
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $51.18 / $8,702.00 / $16,128.00	Facility	TC	$51.18	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $34.85 / $52.27	Professional		$29.62	$34.85	$52.27
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $9.72 / $29.72	Professional	26	$8.22	$9.72	$29.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.40 / $25.85 / $41.12	Professional	TC	$21.40	$25.85	$41.12
United Facility/Professional Facility Modifier Low / Median / High Price $205.13 / $370.90 / $447.23	Facility		$205.13	$370.90	$447.23
United Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $39.70 / $69.56	Professional		$27.70	$39.70	$69.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $11.42 / $20.11	Professional	26	$6.81	$11.42	$20.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $27.34 / $48.17	Professional	TC	$19.32	$27.34	$48.17