Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.25 / $6.25 / $20.30	Facility	26	$6.25	$6.25	$20.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $28.12 / $62.27	Professional		$18.72	$28.12	$62.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $7.49 / $17.00	Professional	26	$6.11	$7.49	$17.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.06 / $14.06 / $14.06	Professional	50	$14.06	$14.06	$14.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.52 / $13.32 / $16.14	Professional	52	$10.52	$13.32	$16.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $20.64 / $32.00	Professional	TC	$14.93	$20.64	$32.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.13 / $18.55 / $28.55	Professional		$13.13	$18.55	$28.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.66 / $5.99 / $12.74	Professional	26	$3.66	$5.99	$12.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $25.70 / $25.70	Professional	50	$25.70	$25.70	$25.70
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $26.35 / $33.29 / $51.75	Professional		$26.35	$33.29	$51.75
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 Professional Modifier Low / Median / High Price $22.55 / $35.88 / $59.19	Professional		$22.55	$35.88	$59.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.61 / $9.58 / $16.12	Professional	26	$5.61	$9.58	$16.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.83 / $24.33 / $39.79	Professional	TC	$15.83	$24.33	$39.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $39.46 / $54.04	Professional		$32.19	$39.46	$54.04
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 $24.45 / $29.33 / $40.10	Professional	TC	$24.45	$29.33	$40.10
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $28.64 / $44.35	Professional		$22.44	$28.64	$44.35
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.79 / $24.34	Professional	26	$6.46	$7.79	$24.34
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.86 / $20.37 / $34.42	Professional	TC	$16.86	$20.37	$34.42
United Facility/Professional Professional Modifier Low / Median / High Price $20.64 / $30.25 / $50.86	Professional		$20.64	$30.25	$50.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.46 / $8.55 / $14.43	Professional	26	$5.46	$8.55	$14.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.82 / $22.23 / $37.00	Professional	TC	$14.82	$22.23	$37.00