Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.53 / $184.68 / $526.14	Facility		$41.53	$184.68	$526.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.57 / $6.57 / $23.55	Facility	26	$6.57	$6.57	$23.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.07 / $41.53 / $201.19	Facility	TC	$17.07	$41.53	$201.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $32.96 / $82.00	Professional		$22.01	$32.96	$82.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $8.25 / $22.16	Professional	26	$6.42	$8.25	$22.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $120.00 / $120.00 / $288.00	Professional	50	$120.00	$120.00	$288.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.22 / $15.50 / $22.79	Professional	52	$11.22	$15.50	$22.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.85 / $22.87 / $42.92	Professional	TC	$16.85	$22.87	$42.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $25.09 / $43.59	Professional		$23.16	$25.09	$43.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $7.05 / $14.85	Professional	26	$5.88	$7.05	$14.85
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $270.70 / $353.22 / $377.58	Facility		$270.70	$353.22	$377.58
AmeriHealth Facility/Professional Facility Modifier TC Low / Median / High Price $2,492.08 / $2,492.08 / $2,492.08	Facility	TC	$2,492.08	$2,492.08	$2,492.08
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $8.76 / $26.65 / $30.00	Professional		$8.76	$26.65	$30.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.11 / $78.59 / $120.53	Facility		$64.11	$78.59	$120.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.27 / $5.27 / $5.27	Facility	26	$5.27	$5.27	$5.27
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $12.86 / $12.86 / $12.86	Facility	TC	$12.86	$12.86	$12.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.55 / $39.11 / $68.78	Professional		$25.55	$39.11	$68.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $10.27 / $17.67	Professional	26	$5.88	$10.27	$17.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.54 / $27.21 / $44.41	Professional	TC	$17.54	$27.21	$44.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $44.89 / $64.30	Professional		$36.04	$44.89	$64.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $10.61 / $14.60	Professional	26	$9.11	$10.61	$14.60
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.36 / $36.44 / $49.70	Professional	TC	$30.36	$36.44	$49.70
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.08 / $214.08 / $243.38	Facility		$214.08	$214.08	$243.38
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $44.68 / $8,702.00 / $16,128.00	Facility	TC	$44.68	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.48 / $33.50 / $46.13	Professional		$28.48	$33.50	$46.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $8.16 / $27.26	Professional	26	$6.77	$8.16	$27.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $24.75 / $41.81	Professional	TC	$20.49	$24.75	$41.81
United Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $33.25 / $58.60	Professional		$23.13	$33.25	$58.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $9.10 / $15.14	Professional	26	$5.97	$9.10	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $25.27 / $45.81	Professional	TC	$16.64	$25.27	$45.81