Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $38.90 / $165.96	Facility	26	$18.62	$38.90	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $295.12	Professional		$72.44	$104.71	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $36.31 / $85.11	Professional	26	$20.89	$36.31	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $72.44 / $169.82	Professional	TC	$52.48	$72.44	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $95.50	Professional		$83.18	$83.18	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $25.12 / $53.70	Professional	26	$21.38	$25.12	$53.70
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $74.13 / $194.98	Professional		$30.90	$74.13	$194.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $190.55	Professional		$70.79	$104.71	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.90 / $56.23	Professional	26	$20.42	$30.90	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $75.86 / $141.25	Professional	TC	$47.86	$75.86	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $181.97	Professional		$112.20	$134.90	$181.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $51.29	Professional	26	$32.36	$38.02	$51.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $95.50 / $131.83	Professional	TC	$79.43	$95.50	$131.83
Horizon BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $190.55	Professional		$83.18	$97.72	$190.55
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $28.84 / $50.12	Professional	26	$24.55	$28.84	$50.12
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $69.18 / $151.36	Professional	TC	$58.88	$69.18	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $173.78	Professional		$63.10	$97.72	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $28.84 / $52.48	Professional	26	$17.78	$28.84	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $69.18 / $128.82	Professional	TC	$45.71	$69.18	$128.82