Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.16 / $9.16 / $29.15	Facility	26	$9.16	$9.16	$29.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.51 / $45.00 / $319.26	Facility	TC	$18.51	$45.00	$319.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $34.72 / $85.29	Professional		$26.14	$34.72	$85.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $11.21 / $28.05	Professional	26	$8.88	$11.21	$28.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $22.25 / $36.71	Professional	TC	$17.39	$22.25	$36.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.17 / $25.31 / $26.17	Professional		$17.17	$25.31	$26.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.69 / $18.25	Professional	26	$8.13	$9.69	$18.25
AmeriHealth Facility/Professional Facility Modifier TC Low / Median / High Price $2,707.20 / $2,707.20 / $2,707.20	Facility	TC	$2,707.20	$2,707.20	$2,707.20
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $16.25 / $20.03 / $70.09	Professional		$16.25	$20.03	$70.09
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $17.96 / $29.40	Professional	26	$13.15	$17.96	$29.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $43.71 / $71.31	Professional		$26.57	$43.71	$71.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $14.01 / $22.96	Professional	26	$7.95	$14.01	$22.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.77 / $30.04 / $47.93	Professional	TC	$18.77	$30.04	$47.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $51.49 / $70.19	Professional		$41.18	$51.49	$70.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.44 / $14.58 / $19.85	Professional	26	$12.44	$14.58	$19.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $36.90 / $50.34	Professional	TC	$30.76	$36.90	$50.34
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $55.26 / $8,702.00 / $16,128.00	Facility	TC	$55.26	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.11 / $35.70 / $55.58	Professional		$24.11	$35.70	$55.58
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $11.21 / $29.78	Professional	26	$9.30	$11.21	$29.78
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $25.33 / $38.84	Professional	TC	$20.49	$25.33	$38.84
United Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $38.47 / $63.93	Professional		$26.23	$38.47	$63.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $12.82 / $20.79	Professional	26	$8.19	$12.82	$20.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.01 / $26.99 / $45.81	Professional	TC	$18.01	$26.99	$45.81