Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $40.74 / $66.07	Facility	26	$11.48	$40.74	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.88 / $107.15	Professional		$19.05	$33.88	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.30 / $33.11	Professional	26	$7.08	$12.30	$33.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $61.66 / $120.23	Professional	50	$54.95	$61.66	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $19.50 / $47.86	Professional	TC	$12.02	$19.50	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.88 / $38.90	Professional		$18.20	$21.88	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.13 / $16.22	Professional	26	$6.76	$8.13	$16.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $30.20 / $32.36	Professional	50	$30.20	$30.20	$32.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $43.65 / $91.20	Professional		$21.88	$43.65	$91.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $5.75 / $5.75	Facility	26	$5.75	$5.75	$5.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $35.48 / $58.88	Professional		$19.95	$35.48	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.96 / $18.62	Professional	26	$6.76	$10.96	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $22.91 / $39.81	Professional	TC	$12.59	$22.91	$39.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $66.07	Professional		$30.20	$35.48	$66.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.30 / $66.07	Professional	26	$10.47	$12.30	$66.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.44 / $66.07	Professional	TC	$19.50	$23.44	$66.07
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $28.18 / $61.66	Professional		$16.60	$28.18	$61.66
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.91 / $22.91	Professional	26	$7.59	$8.91	$22.91
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $43.65	Professional	TC	$16.98	$19.95	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $29.51 / $53.70	Professional		$19.50	$29.51	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.33 / $16.60	Professional	26	$6.46	$9.33	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $20.42 / $37.15	Professional	TC	$12.59	$20.42	$37.15