Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.55 / $14.55 / $76.09	Facility	26	$14.55	$14.55	$76.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.84 / $65.11 / $111.56	Professional		$43.84	$65.11	$111.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $15.71 / $26.08	Professional	26	$12.61	$15.71	$26.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.38 / $46.62 / $76.59	Professional	TC	$31.38	$46.62	$76.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.89 / $42.60 / $62.88	Professional		$36.89	$42.60	$62.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $11.88 / $23.83	Professional	26	$6.84	$11.88	$23.83
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.28 / $72.04 / $118.38	Professional		$15.28	$72.04	$118.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $11.98 / $11.98	Facility	26	$11.98	$11.98	$11.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.25 / $79.62 / $132.35	Professional		$48.25	$79.62	$132.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $20.47 / $35.44	Professional	26	$10.60	$20.47	$35.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.32 / $53.63 / $94.87	Professional	TC	$34.32	$53.63	$94.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $86.66 / $118.11	Professional		$72.73	$86.66	$118.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $18.95 / $26.14	Professional	26	$16.32	$18.95	$26.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.33 / $67.70 / $91.97	Professional	TC	$56.33	$67.70	$91.97
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.54 / $58.57 / $94.25	Professional		$49.54	$58.57	$94.25
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $14.27 / $50.41	Professional	26	$12.13	$14.27	$50.41
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.40 / $44.01 / $73.67	Professional	TC	$37.40	$44.01	$73.67
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.98 / $113.29	Professional		$47.86	$66.98	$113.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $17.44 / $30.16	Professional	26	$10.68	$17.44	$30.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.96 / $49.66 / $84.66	Professional	TC	$34.96	$49.66	$84.66