Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $45.71 / $85.11	Facility	26	$10.47	$45.71	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $48.98 / $128.82	Professional		$33.88	$48.98	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.38 / $36.31	Professional	26	$10.47	$17.38	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $69.18	Professional	TC	$20.89	$30.20	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $32.36 / $70.79	Professional		$28.18	$32.36	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.88 / $25.70	Professional	26	$10.23	$12.88	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $26.30	Professional	TC	$19.95	$19.95	$26.30
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $39.81	Professional		$25.12	$25.12	$39.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $89.13	Professional		$33.88	$53.70	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $28.84	Professional	26	$10.00	$17.38	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $58.88	Professional	TC	$21.88	$33.88	$58.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $60.26 / $83.18	Professional		$51.29	$60.26	$83.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $24.55	Professional	26	$15.49	$18.20	$24.55
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $57.54	Professional	TC	$35.48	$42.66	$57.54
Horizon BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Facility	26	$31.62	$31.62	$31.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $79.43	Professional		$28.84	$43.65	$79.43
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $28.84	Professional	26	$12.02	$14.45	$28.84
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $30.90 / $63.10	Professional	TC	$25.12	$30.90	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $77.62	Professional		$30.90	$44.67	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.14 / $26.30	Professional	26	$9.55	$15.14	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $53.70	Professional	TC	$21.38	$30.20	$53.70