Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.84 / $13.85 / $71.81	Facility	26	$13.84	$13.85	$71.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.46 / $66.06 / $99.35	Professional		$52.46	$66.06	$99.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $16.30 / $23.56	Professional	26	$13.26	$16.30	$23.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.40 / $50.21 / $72.67	Professional	TC	$40.40	$50.21	$72.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $51.78 / $59.33	Professional		$36.99	$51.78	$59.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $13.09 / $13.09	Professional	26	$12.73	$13.09	$13.09
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $31.07 / $31.07 / $31.07	Professional		$31.07	$31.07	$31.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $92.75 / $152.66	Professional		$57.32	$92.75	$152.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $21.72 / $35.40	Professional	26	$12.23	$21.72	$35.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.46 / $70.76 / $112.56	Professional	TC	$44.46	$70.76	$112.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $83.94 / $112.04 / $152.33	Professional		$83.94	$112.04	$152.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.16 / $22.59 / $30.53	Professional	26	$19.16	$22.59	$30.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.48 / $89.45 / $121.80	Professional	TC	$74.48	$89.45	$121.80
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.07 / $75.17 / $104.09	Professional		$63.07	$75.17	$104.09
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $17.28 / $66.84	Professional	26	$14.65	$17.28	$66.84
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.01 / $60.01 / $95.45	Professional	TC	$51.01	$60.01	$95.45
United Facility/Professional Professional Modifier Low / Median / High Price $57.20 / $85.05 / $141.29	Professional		$57.20	$85.05	$141.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $19.82 / $33.81	Professional	26	$12.65	$19.82	$33.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.13 / $65.64 / $110.34	Professional	TC	$42.13	$65.64	$110.34