Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.98 / $5.98 / $31.60	Facility	26	$5.98	$5.98	$31.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.59 / $33.04 / $125.31	Facility	TC	$13.59	$33.04	$125.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.87 / $21.22 / $34.11	Professional		$13.87	$21.22	$34.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $7.16 / $14.44	Professional	26	$5.87	$7.16	$14.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.45 / $14.78 / $24.51	Professional	TC	$11.45	$14.78	$24.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $13.05 / $13.05	Professional		$13.05	$13.05	$13.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.43 / $6.08 / $10.72	Professional	26	$5.43	$6.08	$10.72
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $6.91 / $6.91 / $7.94	Professional		$6.91	$6.91	$7.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.04 / $5.04 / $5.04	Facility	26	$5.04	$5.04	$5.04
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	TC	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $29.68 / $49.19	Professional		$17.43	$29.68	$49.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $9.36 / $15.63	Professional	26	$5.37	$9.36	$15.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.51 / $19.78 / $33.56	Professional	TC	$11.51	$19.78	$33.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $30.04 / $41.32	Professional		$25.38	$30.04	$41.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $9.71 / $13.38	Professional	26	$8.36	$9.71	$13.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $20.32 / $27.92	Professional	TC	$16.98	$20.32	$27.92
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $34.11 / $8,702.00 / $16,128.00	Facility	TC	$34.11	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $17.62 / $30.13	Professional		$12.00	$17.62	$30.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $7.29 / $11.89	Professional	26	$6.19	$7.29	$11.89
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.45 / $18.34 / $26.96	Professional	TC	$13.45	$18.34	$26.96
United Facility/Professional Professional Modifier Low / Median / High Price $16.57 / $24.03 / $41.91	Professional		$16.57	$24.03	$41.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.47 / $8.36 / $14.51	Professional	26	$5.47	$8.36	$14.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.13 / $16.39 / $29.10	Professional	TC	$11.13	$16.39	$29.10