Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.11 / $5.11 / $16.75	Facility	26	$5.11	$5.11	$16.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.73 / $43.08 / $197.45	Facility	TC	$17.73	$43.08	$197.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.94 / $29.69 / $86.40	Professional		$18.94	$29.69	$86.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.08 / $6.20 / $13.69	Professional	26	$5.08	$6.20	$13.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $23.23 / $41.72	Professional	TC	$16.88	$23.23	$41.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.77 / $19.97 / $29.38	Professional		$18.77	$19.97	$29.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $5.13 / $10.54	Professional	26	$4.68	$5.13	$10.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $45.75 / $60.00	Professional		$11.00	$45.75	$60.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.33 / $4.33 / $4.33	Facility	26	$4.33	$4.33	$4.33
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $11.12 / $11.12 / $11.12	Facility	TC	$11.12	$11.12	$11.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.49 / $36.07 / $63.02	Professional		$22.49	$36.07	$63.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.65 / $7.93 / $13.14	Professional	26	$4.65	$7.93	$13.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.14 / $24.73 / $45.07	Professional	TC	$16.14	$24.73	$45.07
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $40.54 / $55.54	Professional		$32.92	$40.54	$55.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $8.38 / $11.62	Professional	26	$7.25	$8.38	$11.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.82 / $32.15 / $43.92	Professional	TC	$26.82	$32.15	$43.92
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $46.32 / $8,702.00 / $16,128.00	Facility	TC	$46.32	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.34 / $28.77 / $43.81	Professional		$22.34	$28.77	$43.81
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.34 / $6.28 / $20.83	Professional	26	$5.34	$6.28	$20.83
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $22.34 / $33.11	Professional	TC	$18.98	$22.34	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $30.58 / $54.17	Professional		$20.23	$30.58	$54.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.69 / $7.17 / $11.91	Professional	26	$4.69	$7.17	$11.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.91 / $24.11 / $42.21	Professional	TC	$15.91	$24.11	$42.21