Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.94 / $163.52 / $446.34	Facility		$42.94	$163.52	$446.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.83 / $6.84 / $21.76	Facility	26	$6.83	$6.84	$21.76
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.67 / $41.86 / $190.78	Facility	TC	$17.67	$41.86	$190.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.05 / $29.48 / $60.57	Professional		$11.05	$29.48	$60.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $8.13 / $23.80	Professional	26	$6.45	$8.13	$23.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.04 / $21.44 / $35.86	Professional	TC	$16.04	$21.44	$35.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $23.87 / $41.35	Professional		$20.89	$23.87	$41.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.22 / $6.47 / $12.74	Professional	26	$5.22	$6.47	$12.74
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $42.04 / $114.90 / $971.04	Facility		$42.04	$114.90	$971.04
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $29.25 / $81.00	Professional		$13.46	$29.25	$81.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $12.52 / $24.80	Professional	26	$9.34	$12.52	$24.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.99 / $74.94 / $114.17	Facility		$59.99	$74.94	$114.17
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 $15.49 / $15.49 / $15.49	Facility	TC	$15.49	$15.49	$15.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.15 / $39.22 / $64.36	Professional		$24.15	$39.22	$64.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $10.16 / $16.78	Professional	26	$5.67	$10.16	$16.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $26.68 / $43.57	Professional	TC	$16.39	$26.68	$43.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $44.68 / $61.08	Professional		$35.36	$44.68	$61.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.15 / $13.96	Professional	26	$8.73	$10.15	$13.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.79 / $34.54 / $47.14	Professional	TC	$28.79	$34.54	$47.14
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.45 / $214.08 / $243.38	Facility		$178.45	$214.08	$243.38
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $8,702.00 / $8,702.00 / $16,128.00	Facility	TC	$8,702.00	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.05 / $31.39 / $48.75	Professional		$26.05	$31.39	$48.75
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $7.97 / $28.64	Professional	26	$6.77	$7.97	$28.64
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.29 / $22.69 / $36.09	Professional	TC	$19.29	$22.69	$36.09
United Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $31.76 / $55.99	Professional		$23.95	$31.76	$55.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.61 / $9.07 / $15.17	Professional	26	$5.61	$9.07	$15.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $23.81 / $42.87	Professional	TC	$16.75	$23.81	$42.87