Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $63.10 / $104.71	Facility	26	$36.31	$63.10	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $158.49	Professional		$38.02	$67.61	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.79 / $39.81	Professional	26	$10.72	$14.79	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $44.67 / $123.03	Professional	TC	$30.90	$44.67	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $87.10	Professional		$42.66	$72.44	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.72 / $12.59	Professional	26	$10.47	$10.72	$12.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	TC	$33.88	$33.88	$33.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $54.95	Professional		$53.70	$53.70	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $70.79 / $123.03	Professional		$44.67	$70.79	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.38 / $28.18	Professional	26	$10.47	$17.38	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $52.48 / $95.50	Professional	TC	$33.88	$52.48	$95.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $107.15	Professional		$75.86	$85.11	$107.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $18.20 / $79.43	Professional	26	$15.85	$18.20	$79.43
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $72.44 / $85.11	Professional	TC	$60.26	$72.44	$85.11
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $57.54 / $112.20	Professional		$48.98	$57.54	$112.20
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $13.18 / $30.20	Professional	26	$11.22	$13.18	$30.20
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $83.18	Professional	TC	$37.15	$43.65	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $102.33	Professional		$42.66	$58.88	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.79 / $25.12	Professional	26	$9.77	$14.79	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $77.62	Professional	TC	$31.62	$44.67	$77.62