Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.74 / $190.82 / $591.41	Facility		$56.74	$190.82	$591.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.83 / $6.84 / $35.92	Facility	26	$6.83	$6.84	$35.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.82 / $46.27 / $263.42	Facility	TC	$15.82	$46.27	$263.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.20 / $28.86 / $83.10	Professional		$11.20	$28.86	$83.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $8.35 / $29.13	Professional	26	$6.52	$8.35	$29.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.32 / $178.25 / $259.50	Professional	50	$45.32	$178.25	$259.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.76 / $20.13 / $41.46	Professional	TC	$15.76	$20.13	$41.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.66 / $23.63 / $40.92	Professional		$14.66	$23.63	$40.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.66 / $6.78 / $11.89	Professional	26	$5.66	$6.78	$11.89
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $43.99 / $187.77 / $4,406.64	Facility		$43.99	$187.77	$4,406.64
AmeriHealth Facility/Professional Facility Modifier TC Low / Median / High Price $2,038.92 / $2,038.92 / $2,038.92	Facility	TC	$2,038.92	$2,038.92	$2,038.92
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $8.35 / $27.95 / $61.75	Professional		$8.35	$27.95	$61.75
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $12.52 / $24.80	Professional	26	$9.14	$12.52	$24.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.17 / $72.55 / $112.60	Facility		$59.17	$72.55	$112.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.76 / $5.76 / $5.76	Facility	26	$5.76	$5.76	$5.76
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $13.61 / $13.61 / $13.61	Facility	TC	$13.61	$13.61	$13.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $37.63 / $62.36	Professional		$23.86	$37.63	$62.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.61 / $10.07 / $16.78	Professional	26	$5.61	$10.07	$16.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.18 / $24.91 / $39.36	Professional	TC	$16.18	$24.91	$39.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $44.21 / $60.46	Professional		$32.86	$44.21	$60.46
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.15 / $13.96	Professional	26	$8.73	$10.15	$13.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $34.06 / $46.50	Professional	TC	$28.39	$34.06	$46.50
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.75 / $214.08 / $379.92	Facility		$172.75	$214.08	$379.92
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $39.82 / $8,702.00 / $16,128.00	Facility	TC	$39.82	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $29.94 / $47.61	Professional		$25.45	$29.94	$47.61
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.61 / $26.35	Professional	26	$6.46	$7.61	$26.35
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $22.33 / $35.52	Professional	TC	$18.98	$22.33	$35.52
United Facility/Professional Professional Modifier Low / Median / High Price $22.57 / $31.04 / $54.70	Professional		$22.57	$31.04	$54.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $8.89 / $14.58	Professional	26	$5.72	$8.89	$14.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.99 / $24.59 / $42.29	Professional	TC	$15.99	$24.59	$42.29