Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.05 / $16.05 / $83.25	Facility	26	$16.05	$16.05	$83.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.61 / $83.18 / $137.24	Professional		$64.61	$83.18	$137.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.33 / $18.92 / $30.95	Professional	26	$15.33	$18.92	$30.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.25 / $62.96 / $95.69	Professional	TC	$51.25	$62.96	$95.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $58.35 / $58.35	Professional		$58.35	$58.35	$58.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.95 / $14.95 / $14.95	Professional	26	$14.95	$14.95	$14.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.02 / $112.57 / $188.39	Professional		$72.02	$112.57	$188.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $25.51 / $40.98	Professional	26	$14.36	$25.51	$40.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.05 / $84.86 / $141.34	Professional	TC	$56.05	$84.86	$141.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.39 / $137.78 / $187.51	Professional		$100.39	$137.78	$187.51
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $26.53 / $36.22	Professional	26	$22.69	$26.53	$36.22
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $92.60 / $111.25 / $151.27	Professional	TC	$92.60	$111.25	$151.27
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.89 / $91.64 / $140.00	Professional		$77.89	$91.64	$140.00
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $20.03 / $95.83	Professional	26	$16.61	$20.03	$95.83
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.29 / $75.77 / $104.96	Professional	TC	$61.29	$75.77	$104.96
United Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $96.08 / $169.91	Professional		$67.73	$96.08	$169.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.85 / $22.65 / $37.65	Professional	26	$14.85	$22.65	$37.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.22 / $75.88 / $138.65	Professional	TC	$52.22	$75.88	$138.65