Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.93 / $11.94 / $61.89	Facility	26	$11.93	$11.94	$61.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.50 / $70.40 / $347.46	Facility	TC	$28.50	$70.40	$347.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.46 / $50.07 / $80.81	Professional		$38.46	$50.07	$80.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.03 / $27.92	Professional	26	$11.48	$14.03	$27.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.36 / $33.46 / $53.21	Professional	TC	$26.36	$33.46	$53.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $40.13 / $54.74	Professional		$25.02	$40.13	$54.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $12.32 / $17.55	Professional	26	$10.48	$12.32	$17.55
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.19 / $42.50 / $62.13	Professional		$13.19	$42.50	$62.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $64.98 / $106.56	Professional		$39.15	$64.98	$106.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $18.11 / $29.90	Professional	26	$10.37	$18.11	$29.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $46.06 / $73.92	Professional	TC	$29.00	$46.06	$73.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.23 / $75.39 / $102.43	Professional		$60.23	$75.39	$102.43
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.80 / $18.57 / $25.20	Professional	26	$15.80	$18.57	$25.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.28 / $56.81 / $77.23	Professional	TC	$47.28	$56.81	$77.23
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $8,702.00 / $8,702.00 / $16,128.00	Facility	TC	$8,702.00	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $50.85 / $75.33	Professional		$43.22	$50.85	$75.33
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.85 / $13.94 / $34.26	Professional	26	$11.85	$13.94	$34.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.37 / $38.78 / $60.11	Professional	TC	$31.37	$38.78	$60.11
United Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $51.90 / $92.70	Professional		$37.22	$51.90	$92.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.40 / $16.68 / $28.08	Professional	26	$10.40	$16.68	$28.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $41.59 / $70.70	Professional	TC	$27.87	$41.59	$70.70