Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.31 / $10.47 / $48.98	Facility	26	$6.31	$10.47	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $37.15 / $104.71	Professional		$15.85	$37.15	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $12.59 / $36.31	Professional	26	$6.03	$12.59	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $114.82 / $263.03	Professional	50	$48.98	$114.82	$263.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.88 / $21.88 / $36.31	Professional	52	$21.88	$21.88	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $61.66	Professional	TC	$15.14	$22.91	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $33.88	Professional		$18.20	$25.12	$33.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.24 / $17.38	Professional	26	$5.75	$7.24	$17.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.62 / $31.62 / $33.11	Professional	50	$31.62	$31.62	$33.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $19.05 / $27.54	Professional	TC	$14.45	$19.05	$27.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $33.11 / $51.29	Professional		$13.49	$33.11	$51.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.25 / $5.25 / $5.25	Facility	26	$5.25	$5.25	$5.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $35.48 / $60.26	Professional		$22.91	$35.48	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $9.77 / $16.22	Professional	26	$5.89	$9.77	$16.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $41.69	Professional	TC	$15.85	$23.99	$41.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $54.95	Professional		$33.88	$40.74	$54.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.47 / $14.45	Professional	26	$8.91	$10.47	$14.45
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $30.20 / $40.74	Professional	TC	$25.12	$30.20	$40.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $28.84 / $54.95	Professional		$24.55	$28.84	$54.95
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.76 / $16.98	Professional	26	$6.61	$7.76	$16.98
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $20.89 / $45.71	Professional	TC	$17.78	$20.89	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $29.51 / $51.29	Professional		$19.95	$29.51	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $8.32 / $14.45	Professional	26	$5.50	$8.32	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $20.89 / $38.02	Professional	TC	$14.13	$20.89	$38.02