Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.55 / $14.55 / $70.41	Facility	26	$14.55	$14.55	$70.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.35 / $67.45 / $132.74	Professional		$48.35	$67.45	$132.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $16.17 / $26.64	Professional	26	$12.39	$16.17	$26.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.85 / $50.07 / $81.17	Professional	TC	$35.85	$50.07	$81.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $45.63 / $62.19	Professional		$39.93	$45.63	$62.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $12.96 / $24.40	Professional	26	$11.09	$12.96	$24.40
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $103.42 / $205.79	Professional		$68.56	$103.42	$205.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $11.98 / $11.98	Facility	26	$11.98	$11.98	$11.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.77 / $81.93 / $138.88	Professional		$48.77	$81.93	$138.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $20.21 / $33.57	Professional	26	$10.82	$20.21	$33.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.65 / $58.25 / $102.50	Professional	TC	$35.65	$58.25	$102.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.94 / $85.71 / $116.82	Professional		$71.94	$85.71	$116.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $19.43 / $26.78	Professional	26	$16.73	$19.43	$26.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.15 / $66.29 / $90.04	Professional	TC	$55.15	$66.29	$90.04
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.54 / $58.89 / $93.25	Professional		$49.54	$58.89	$93.25
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $14.27 / $51.37	Professional	26	$12.13	$14.27	$51.37
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.40 / $45.19 / $77.66	Professional	TC	$37.40	$45.19	$77.66
United Facility/Professional Professional Modifier Low / Median / High Price $47.21 / $66.98 / $115.40	Professional		$47.21	$66.98	$115.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $15.48 / $26.53	Professional	26	$10.53	$15.48	$26.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.21 / $50.58 / $85.97	Professional	TC	$36.21	$50.58	$85.97