Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $44.67 / $81.28	Facility	26	$10.47	$44.67	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $162.18	Professional		$32.36	$51.29	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $18.20 / $50.12	Professional	26	$10.00	$18.20	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $81.28	Professional	TC	$20.89	$30.20	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.18 / $32.36	Professional		$22.91	$28.18	$32.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.72 / $12.30	Professional	26	$10.72	$10.72	$12.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $32.36	Professional	TC	$25.12	$25.12	$32.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $52.48 / $89.13	Professional		$31.62	$52.48	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $26.30	Professional	26	$9.55	$16.22	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $35.48 / $63.10	Professional	TC	$22.91	$35.48	$63.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $85.11	Professional		$52.48	$63.10	$85.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $17.38 / $23.99	Professional	26	$14.79	$17.38	$23.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $45.71 / $61.66	Professional	TC	$38.02	$45.71	$61.66
Horizon BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $74.13	Professional		$33.88	$41.69	$74.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.88 / $25.70	Professional	26	$10.96	$12.88	$25.70
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $29.51 / $57.54	Professional	TC	$25.12	$29.51	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $75.86	Professional		$30.20	$43.65	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.13 / $24.55	Professional	26	$9.12	$14.13	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $29.51 / $52.48	Professional	TC	$21.38	$29.51	$52.48