Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.69 / $21.69 / $113.41	Facility	26	$21.69	$21.69	$113.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.09 / $109.99 / $169.82	Professional		$83.09	$109.99	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $25.14 / $39.56	Professional	26	$20.69	$25.14	$39.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.86 / $84.13 / $130.24	Professional	TC	$64.86	$84.13	$130.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.90 / $91.90 / $91.90	Professional		$91.90	$91.90	$91.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.49 / $23.49 / $53.52	Professional	26	$23.49	$23.49	$53.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.64 / $17.64 / $17.64	Facility	26	$17.64	$17.64	$17.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.53 / $137.99 / $214.63	Professional		$91.53	$137.99	$214.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $32.82 / $54.62	Professional	26	$19.55	$32.82	$54.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.34 / $101.96 / $165.92	Professional	TC	$67.34	$101.96	$165.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.94 / $175.49 / $246.13	Professional		$125.94	$175.49	$246.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $35.39 / $48.48	Professional	26	$30.32	$35.39	$48.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $121.26 / $145.90 / $197.64	Professional	TC	$121.26	$145.90	$197.64
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.75 / $119.76 / $177.76	Professional		$100.75	$119.76	$177.76
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.95 / $25.82 / $45.56	Professional	26	$21.95	$25.82	$45.56
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.80 / $97.44 / $151.00	Professional	TC	$78.80	$97.44	$151.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $119.16 / $214.69	Professional		$85.59	$119.16	$214.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.54 / $30.09 / $49.01	Professional	26	$19.54	$30.09	$49.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.26 / $99.43 / $173.30	Professional	TC	$69.26	$99.43	$173.30