Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.77 / $10.78 / $55.84	Facility	26	$10.77	$10.78	$55.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.55 / $62.52 / $263.83	Facility	TC	$21.55	$62.52	$263.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $40.00 / $71.67	Professional		$30.65	$40.00	$71.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $12.66 / $19.55	Professional	26	$10.43	$12.66	$19.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $26.30 / $38.13	Professional	TC	$20.22	$26.30	$38.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $31.83 / $31.83	Professional		$31.83	$31.83	$31.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.39 / $10.47 / $25.95	Professional	26	$9.39	$10.47	$25.95
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.71 / $23.04 / $31.68	Professional		$13.71	$23.04	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $51.26 / $83.40	Professional		$31.17	$51.26	$83.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $16.38 / $27.06	Professional	26	$9.36	$16.38	$27.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $34.88 / $55.81	Professional	TC	$21.87	$34.88	$55.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.10 / $59.36 / $80.80	Professional		$48.10	$59.36	$80.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.29 / $16.78 / $22.77	Professional	26	$14.29	$16.78	$22.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $42.59 / $58.01	Professional	TC	$35.47	$42.59	$58.01
Horizon BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $56.06 / $8,702.00 / $16,128.00	Facility	TC	$56.06	$8,702.00	$16,128.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.89 / $35.97 / $53.49	Professional		$12.89	$35.97	$53.49
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $12.58 / $44.37	Professional	26	$10.69	$12.58	$44.37
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $28.02 / $42.02	Professional	TC	$23.82	$28.02	$42.02
United Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $46.06 / $74.06	Professional		$30.69	$46.06	$74.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $14.78 / $23.91	Professional	26	$9.25	$14.78	$23.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $30.79 / $53.10	Professional	TC	$20.57	$30.79	$53.10