Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.67 / $181.83 / $528.50	Facility		$37.67	$181.83	$528.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.25 / $6.25 / $19.35	Facility	26	$6.25	$6.25	$19.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.50 / $37.67 / $182.99	Facility	TC	$15.50	$37.67	$182.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $28.41 / $75.62	Professional		$19.23	$28.41	$75.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.84 / $7.43 / $20.18	Professional	26	$5.84	$7.43	$20.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.50 / $157.33 / $166.65	Professional	50	$43.50	$157.33	$166.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $13.32 / $17.57	Professional	52	$10.10	$13.32	$17.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.37 / $20.29 / $30.35	Professional	TC	$14.37	$20.29	$30.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.38 / $19.53 / $21.20	Professional		$18.38	$19.53	$21.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.44 / $6.58 / $14.54	Professional	26	$5.44	$6.58	$14.54
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $193.06 / $334.90 / $486.71	Facility		$193.06	$334.90	$486.71
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.14 / $26.65 / $58.50	Professional		$13.14	$26.65	$58.50
AmeriHealth Facility/Professional Professional Modifier 52 Low / Median / High Price $6.36 / $6.36 / $6.36	Professional	52	$6.36	$6.36	$6.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.58 / $64.50 / $98.61	Facility		$52.58	$64.50	$98.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.27 / $5.27 / $5.27	Facility	26	$5.27	$5.27	$5.27
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $12.86 / $12.86 / $12.86	Facility	TC	$12.86	$12.86	$12.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.98 / $35.40 / $58.66	Professional		$21.98	$35.40	$58.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.34 / $9.28 / $15.52	Professional	26	$5.34	$9.28	$15.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.37 / $24.17 / $38.54	Professional	TC	$15.37	$24.17	$38.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $39.46 / $67.52	Professional		$31.66	$39.46	$67.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $9.68 / $67.52	Professional	26	$8.33	$9.68	$67.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.85 / $29.80 / $67.52	Professional	TC	$24.85	$29.80	$67.52
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.86 / $178.45 / $214.08	Facility		$31.86	$178.45	$214.08
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 $23.03 / $27.09 / $42.66	Professional		$23.03	$27.09	$42.66
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $7.25 / $25.19	Professional	26	$6.16	$7.25	$25.19
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.86 / $19.84 / $35.01	Professional	TC	$16.86	$19.84	$35.01
United Facility/Professional Professional Modifier Low / Median / High Price $20.63 / $30.22 / $50.26	Professional		$20.63	$30.22	$50.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.34 / $8.56 / $13.98	Professional	26	$5.34	$8.56	$13.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.40 / $21.88 / $38.09	Professional	TC	$15.40	$21.88	$38.09