Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.77 / $12.78 / $39.72	Facility	26	$12.77	$12.78	$39.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.38 / $64.14 / $127.18	Professional		$48.38	$64.14	$127.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $15.02 / $31.73	Professional	26	$12.26	$15.02	$31.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $47.66 / $73.94	Professional	TC	$36.22	$47.66	$73.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.53 / $52.22 / $91.40	Professional		$45.53	$52.22	$91.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $13.26 / $18.64	Professional	26	$11.70	$13.26	$18.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $22.75 / $109.46	Professional		$16.22	$22.75	$109.46
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $24.49 / $132.00	Professional	26	$15.17	$24.49	$132.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.17 / $83.67 / $137.85	Professional		$51.17	$83.67	$137.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $19.38 / $32.03	Professional	26	$11.09	$19.38	$32.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $63.69 / $101.47	Professional	TC	$39.84	$63.69	$101.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $77.34 / $98.46 / $134.05	Professional		$77.34	$98.46	$134.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $19.86 / $27.34	Professional	26	$17.09	$19.86	$27.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.38 / $78.61 / $106.69	Professional	TC	$65.38	$78.61	$106.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.41 / $66.36 / $98.31	Professional		$56.41	$66.36	$98.31
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.95 / $15.27 / $62.77	Professional	26	$12.95	$15.27	$62.77
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.45 / $53.73 / $85.57	Professional	TC	$43.45	$53.73	$85.57
United Facility/Professional Professional Modifier Low / Median / High Price $50.61 / $72.45 / $121.90	Professional		$50.61	$72.45	$121.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $17.52 / $29.87	Professional	26	$10.62	$17.52	$29.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.90 / $57.17 / $98.74	Professional	TC	$36.90	$57.17	$98.74