Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $38.90 / $61.66	Facility	26	$21.88	$38.90	$61.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $61.66 / $147.91	Facility	TC	$39.81	$61.66	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $28.18 / $70.79	Professional		$18.20	$28.18	$70.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.55 / $34.67	Professional	26	$6.03	$9.55	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $52.48	Professional	TC	$15.14	$20.89	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $21.38 / $25.70	Professional		$19.95	$21.38	$25.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.59 / $13.80	Professional	26	$6.46	$7.59	$13.80
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $14.13	Professional		$14.13	$14.13	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $37.15 / $61.66	Professional		$21.88	$37.15	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.47 / $16.98	Professional	26	$6.17	$10.47	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $26.30 / $45.71	Professional	TC	$16.22	$26.30	$45.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $57.54	Professional		$35.48	$41.69	$57.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.96 / $15.14	Professional	26	$9.33	$10.96	$15.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.90 / $42.66	Professional	TC	$25.70	$30.90	$42.66
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $11,481.54 / $25,118.86	Facility	TC	$29.51	$11,481.54	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $29.51 / $56.23	Professional		$25.12	$29.51	$56.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.13 / $17.78	Professional	26	$6.92	$8.13	$17.78
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $21.38 / $43.65	Professional	TC	$18.20	$21.38	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.90 / $52.48	Professional		$21.88	$30.90	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.91 / $15.14	Professional	26	$5.75	$8.91	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.39 / $38.90	Professional	TC	$15.49	$22.39	$38.90