Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.41 / $11.41 / $59.09	Facility	26	$11.41	$11.41	$59.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $53.10 / $81.16	Professional		$40.11	$53.10	$81.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $13.01 / $18.93	Professional	26	$10.97	$13.01	$18.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $38.51 / $57.77	Professional	TC	$30.06	$38.51	$57.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $45.10 / $54.78	Professional		$41.68	$45.10	$54.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $10.42 / $18.30	Professional	26	$9.81	$10.42	$18.30
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $54.82	Professional		$53.70	$53.70	$54.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.13 / $69.16 / $115.83	Professional		$43.13	$69.16	$115.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $17.17 / $28.35	Professional	26	$9.61	$17.17	$28.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $51.94 / $82.51	Professional	TC	$33.36	$51.94	$82.51
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $84.90 / $115.76	Professional		$63.96	$84.90	$115.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.25 / $17.66 / $24.44	Professional	26	$15.25	$17.66	$24.44
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.94 / $67.23 / $91.33	Professional	TC	$55.94	$67.23	$91.33
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $54.82 / $86.10	Professional		$46.60	$54.82	$86.10
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $13.27 / $54.46	Professional	26	$11.00	$13.27	$54.46
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $43.00 / $66.14	Professional	TC	$35.60	$43.00	$66.14
United Facility/Professional Professional Modifier Low / Median / High Price $42.39 / $62.33 / $102.84	Professional		$42.39	$62.33	$102.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $15.19 / $25.12	Professional	26	$9.94	$15.19	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.29 / $46.68 / $80.09	Professional	TC	$31.29	$46.68	$80.09