Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.39 / $176.01 / $326.66	Facility		$37.39	$176.01	$326.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.83 / $6.84 / $23.43	Facility	26	$6.83	$6.84	$23.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.86 / $41.40 / $154.41	Facility	TC	$14.86	$41.40	$154.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.71 / $28.05 / $62.43	Professional		$21.71	$28.05	$62.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $8.66 / $20.03	Professional	26	$6.71	$8.66	$20.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.86 / $18.53 / $33.92	Professional	TC	$14.86	$18.53	$33.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.99 / $19.30 / $28.15	Professional		$12.99	$19.30	$28.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $7.35 / $15.48	Professional	26	$6.14	$7.35	$15.48
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $40.95 / $174.82 / $568.96	Facility		$40.95	$174.82	$568.96
AmeriHealth Facility/Professional Facility Modifier TC Low / Median / High Price $1,887.89 / $1,887.89 / $1,887.89	Facility	TC	$1,887.89	$1,887.89	$1,887.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $7.92 / $27.95 / $53.42	Professional		$7.92	$27.95	$53.42
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $13.62 / $26.71	Professional	26	$9.96	$13.62	$26.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.47 / $60.90 / $92.57	Facility		$48.47	$60.90	$92.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.76 / $5.76 / $5.76	Facility	26	$5.76	$5.76	$5.76
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $13.61 / $13.61 / $13.61	Facility	TC	$13.61	$13.61	$13.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $37.21 / $60.48	Professional		$21.70	$37.21	$60.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $10.64 / $18.07	Professional	26	$6.12	$10.64	$18.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.70 / $23.95 / $40.58	Professional	TC	$14.70	$23.95	$40.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $38.95 / $53.33	Professional		$31.70	$38.95	$53.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.48 / $11.05 / $15.16	Professional	26	$9.48	$11.05	$15.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $27.90 / $38.15	Professional	TC	$23.28	$27.90	$38.15
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.63 / $249.00 / $458.84	Facility		$208.63	$249.00	$458.84
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $37.38 / $8,702.00 / $16,128.00	Facility	TC	$37.38	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $27.77 / $43.40	Professional		$23.60	$27.77	$43.40
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.04 / $8.49 / $25.92	Professional	26	$7.04	$8.49	$25.92
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $19.48 / $31.49	Professional	TC	$16.57	$19.48	$31.49
United Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $31.15 / $54.85	Professional		$21.51	$31.15	$54.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.10 / $9.76 / $15.80	Professional	26	$6.10	$9.76	$15.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.55 / $21.21 / $39.13	Professional	TC	$14.55	$21.21	$39.13