Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $16.98 / $97.72	Facility	26	$12.30	$16.98	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $72.44 / $177.83	Professional		$43.65	$72.44	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $53.70	Professional	26	$10.96	$20.42	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $102.33	Professional	TC	$30.90	$45.71	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $77.62	Professional		$33.11	$44.67	$77.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.02 / $21.38	Professional	26	$9.77	$12.02	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $35.48 / $48.98	Professional	TC	$26.92	$35.48	$48.98
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $50.12 / $109.65	Professional		$13.49	$50.12	$109.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $10.00	Facility	26	$10.00	$10.00	$10.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $109.65	Professional		$41.69	$66.07	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.78 / $28.84	Professional	26	$10.00	$17.78	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $43.65 / $75.86	Professional	TC	$28.84	$43.65	$75.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $120.23	Professional		$64.57	$75.86	$120.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $17.38 / $120.23	Professional	26	$14.79	$17.38	$120.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $58.88 / $120.23	Professional	TC	$48.98	$58.88	$120.23
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $97.72	Professional		$40.74	$48.98	$97.72
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $12.59 / $33.11	Professional	26	$10.72	$12.59	$33.11
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $37.15 / $75.86	Professional	TC	$31.62	$37.15	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $53.70 / $93.33	Professional		$38.02	$53.70	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $26.30	Professional	26	$9.12	$14.45	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $69.18	Professional	TC	$28.18	$38.90	$69.18