Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $45.71 / $81.28	Facility	26	$10.72	$45.71	$81.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $81.28 / $194.98	Facility	TC	$40.74	$81.28	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $125.89	Professional		$32.36	$44.67	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $31.62	Professional	26	$10.00	$16.60	$31.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $64.57	Professional	TC	$20.89	$28.84	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $36.31 / $38.90	Professional		$35.48	$36.31	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.75 / $22.39	Professional	26	$9.55	$11.75	$22.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $22.39 / $27.54	Professional	TC	$21.88	$22.39	$27.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $13.80 / $31.62	Professional		$13.80	$13.80	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.48 / $91.20	Professional		$32.36	$52.48	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.60 / $27.54	Professional	26	$9.77	$16.60	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $35.48 / $64.57	Professional	TC	$22.91	$35.48	$64.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $81.28	Professional		$50.12	$60.26	$81.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $22.91	Professional	26	$14.45	$16.98	$22.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $58.88	Professional	TC	$35.48	$42.66	$58.88
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $9,120.11 / $25,118.86	Facility	TC	$30.20	$9,120.11	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $42.66 / $77.62	Professional		$34.67	$42.66	$77.62
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.88 / $24.55	Professional	26	$10.96	$12.88	$24.55
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $29.51 / $57.54	Professional	TC	$25.12	$29.51	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $75.86	Professional		$30.90	$44.67	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $24.55	Professional	26	$9.12	$14.45	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $51.29	Professional	TC	$20.42	$29.51	$51.29