Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.83 / $12.84 / $66.33	Facility	26	$12.83	$12.84	$66.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.87 / $63.42 / $269.51	Facility	TC	$21.87	$63.42	$269.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.69 / $42.45 / $65.58	Professional		$32.69	$42.45	$65.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $14.49 / $22.55	Professional	26	$12.19	$14.49	$22.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $26.41 / $36.01	Professional	TC	$20.50	$26.41	$36.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.37 / $31.37 / $31.37	Professional		$31.37	$31.37	$31.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $12.92 / $14.00	Professional	26	$12.92	$12.92	$14.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $53.26 / $53.26 / $53.26	Professional		$53.26	$53.26	$53.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $54.93 / $91.62	Professional		$33.33	$54.93	$91.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $19.16 / $31.71	Professional	26	$10.85	$19.16	$31.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $35.49 / $56.59	Professional	TC	$22.50	$35.49	$56.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $51.55 / $63.45 / $86.26	Professional		$51.55	$63.45	$86.26
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.53 / $19.44 / $26.33	Professional	26	$16.53	$19.44	$26.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.65 / $44.01 / $59.94	Professional	TC	$36.65	$44.01	$59.94
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $8,702.00 / $8,702.00 / $16,128.00	Facility	TC	$8,702.00	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $43.67 / $60.50	Professional		$33.50	$43.67	$60.50
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $15.34 / $37.29	Professional	26	$13.01	$15.34	$37.29
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $29.13 / $49.22	Professional	TC	$24.12	$29.13	$49.22
United Facility/Professional Professional Modifier Low / Median / High Price $33.06 / $46.69 / $79.64	Professional		$33.06	$46.69	$79.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $17.39 / $28.27	Professional	26	$10.54	$17.39	$28.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.93 / $31.23 / $54.08	Professional	TC	$20.93	$31.23	$54.08