Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.67 / $6.68 / $34.57	Facility	26	$6.67	$6.68	$34.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.35 / $40.82 / $169.98	Facility	TC	$16.35	$40.82	$169.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.91 / $26.85 / $43.10	Professional		$19.91	$26.85	$43.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.39 / $7.84 / $12.35	Professional	26	$6.39	$7.84	$12.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.20 / $19.00 / $28.04	Professional	TC	$15.20	$19.00	$28.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.17 / $22.17 / $22.17	Professional		$22.17	$22.17	$22.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $6.63 / $16.47	Professional	26	$5.92	$6.63	$16.47
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $14.23 / $14.23	Professional		$14.23	$14.23	$14.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.87 / $36.21 / $59.44	Professional		$21.87	$36.21	$59.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $10.22 / $17.04	Professional	26	$5.82	$10.22	$17.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.63 / $25.76 / $42.22	Professional	TC	$15.63	$25.76	$42.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $41.36 / $56.61	Professional		$33.61	$41.36	$56.61
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 $25.64 / $30.75 / $42.01	Professional	TC	$25.64	$30.75	$42.01
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $37.90 / $8,702.00 / $16,128.00	Facility	TC	$37.90	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $29.76 / $42.25	Professional		$24.24	$29.76	$42.25
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $7.96 / $14.90	Professional	26	$6.77	$7.96	$14.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $21.59 / $34.32	Professional	TC	$17.48	$21.59	$34.32
United Facility/Professional Professional Modifier Low / Median / High Price $22.42 / $32.40 / $52.07	Professional		$22.42	$32.40	$52.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.86 / $9.35 / $15.17	Professional	26	$5.86	$9.35	$15.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.34 / $23.02 / $38.50	Professional	TC	$15.34	$23.02	$38.50