Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $7.51 / $38.89	Facility	26	$7.50	$7.51	$38.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.96 / $41.14 / $190.78	Facility	TC	$16.96	$41.14	$190.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $28.55 / $56.54	Professional		$21.73	$28.55	$56.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $8.84 / $18.00	Professional	26	$7.17	$8.84	$18.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.76 / $19.89 / $30.34	Professional	TC	$15.76	$19.89	$30.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.89 / $19.89 / $19.89	Professional		$19.89	$19.89	$19.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.10 / $8.44 / $13.15	Professional	26	$6.10	$8.44	$13.15
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.90 / $22.59 / $27.20	Professional		$15.90	$22.59	$27.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.85 / $39.53 / $64.94	Professional		$23.85	$39.53	$64.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $11.50 / $19.13	Professional	26	$6.53	$11.50	$19.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.26 / $27.53 / $44.00	Professional	TC	$17.26	$27.53	$44.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $46.49 / $63.51	Professional		$36.44	$46.49	$63.51
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $11.95 / $16.37	Professional	26	$10.24	$11.95	$16.37
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 TC Low / Median / High Price $45.68 / $8,702.00 / $16,128.00	Facility	TC	$45.68	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $31.54 / $44.23	Professional		$27.45	$31.54	$44.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $9.19 / $30.92	Professional	26	$7.62	$9.19	$30.92
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $23.09 / $35.27	Professional	TC	$18.68	$23.09	$35.27
United Facility/Professional Professional Modifier Low / Median / High Price $24.19 / $33.07 / $56.93	Professional		$24.19	$33.07	$56.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $10.23 / $17.03	Professional	26	$6.60	$10.23	$17.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.84 / $24.62 / $42.40	Professional	TC	$16.84	$24.62	$42.40