Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $165.96 / $489.78	Facility		$39.81	$165.96	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $10.72 / $51.29	Facility	26	$6.03	$10.72	$51.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $56.23 / $147.91	Facility	TC	$22.91	$56.23	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $33.11 / $107.15	Professional		$14.45	$33.11	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $13.18 / $37.15	Professional	26	$6.76	$13.18	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $114.82 / $251.19	Professional	50	$34.67	$114.82	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.44 / $53.70	Professional	TC	$15.85	$23.44	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.91 / $40.74	Professional		$18.62	$22.91	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $7.59 / $15.14	Professional	26	$6.31	$7.59	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $37.15 / $74.13	Professional	50	$37.15	$37.15	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $19.05 / $26.92	Professional	TC	$15.49	$19.05	$26.92
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $269.15 / $346.74	Facility		$194.98	$269.15	$346.74
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $10.23 / $67.61	Professional		$8.71	$10.23	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $56.23 / $100.00	Facility		$52.48	$56.23	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $5.01 / $5.01	Facility	26	$5.01	$5.01	$5.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $13.49 / $13.49 / $13.49	Facility	TC	$13.49	$13.49	$13.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $36.31 / $61.66	Professional		$23.44	$36.31	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $9.55 / $16.98	Professional	26	$6.17	$9.55	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $24.55 / $41.69	Professional	TC	$16.22	$24.55	$41.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $57.54	Professional		$35.48	$41.69	$57.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.96 / $15.14	Professional	26	$9.33	$10.96	$15.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.90 / $42.66	Professional	TC	$25.70	$30.90	$42.66
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $245.47 / $467.74	Facility		$169.82	$245.47	$467.74
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $8,709.64 / $25,118.86	Facility	TC	$22.91	$8,709.64	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $28.84 / $56.23	Professional		$24.55	$28.84	$56.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.13 / $16.98	Professional	26	$6.92	$8.13	$16.98
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $20.89 / $43.65	Professional	TC	$17.78	$20.89	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $131.83 / $204.17	Facility		$81.28	$131.83	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $30.20 / $52.48	Professional		$20.42	$30.20	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $8.71 / $14.79	Professional	26	$5.62	$8.71	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $21.88 / $38.02	Professional	TC	$14.79	$21.88	$38.02