Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $24.55 / $112.20	Facility	26	$14.45	$24.55	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $218.78	Professional		$52.48	$83.18	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $22.39 / $60.26	Professional	26	$12.02	$22.39	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $51.29 / $125.89	Professional	TC	$33.88	$51.29	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $70.79	Professional		$38.02	$51.29	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $12.59 / $21.38	Professional	26	$10.72	$12.59	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $56.23 / $117.49	Professional		$15.14	$56.23	$117.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.02 / $12.02	Facility	26	$12.02	$12.02	$12.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $131.83	Professional		$50.12	$77.62	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $20.89 / $33.88	Professional	26	$11.22	$20.89	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $53.70 / $95.50	Professional	TC	$34.67	$53.70	$95.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $123.03	Professional		$75.86	$89.13	$123.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.50 / $26.92	Professional	26	$16.98	$19.50	$26.92
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $70.79 / $95.50	Professional	TC	$58.88	$70.79	$95.50
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $60.26 / $123.03	Professional		$51.29	$60.26	$123.03
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.45 / $35.48	Professional	26	$12.30	$14.45	$35.48
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $46.77 / $100.00	Professional	TC	$38.90	$46.77	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $114.82	Professional		$45.71	$64.57	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.98 / $30.20	Professional	26	$10.47	$16.98	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $47.86 / $87.10	Professional	TC	$33.88	$47.86	$87.10