Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.98 / $27.98 / $100.60	Facility	26	$27.98	$27.98	$100.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.50 / $114.17 / $221.81	Professional		$87.50	$114.17	$221.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $34.39 / $68.83	Professional	26	$26.27	$34.39	$68.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.23 / $80.54 / $119.07	Professional	TC	$61.23	$80.54	$119.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $62.99 / $62.99	Professional		$62.99	$62.99	$62.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.46 / $33.57 / $70.70	Professional	26	$28.46	$33.57	$70.70
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $50.70 / $68.25 / $68.40	Professional		$50.70	$68.25	$68.40
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $44.89 / $62.02 / $97.98	Professional	26	$44.89	$62.02	$97.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $22.69 / $22.69	Facility	26	$22.69	$22.69	$22.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.64 / $131.79 / $223.96	Professional		$90.64	$131.79	$223.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $43.96 / $71.70	Professional	26	$27.04	$43.96	$71.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.10 / $91.08 / $162.97	Professional	TC	$58.10	$91.08	$162.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $164.27 / $227.98	Professional		$129.31	$164.27	$227.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.07 / $50.30 / $68.77	Professional	26	$43.07	$50.30	$68.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.66 / $117.46 / $159.21	Professional	TC	$97.66	$117.46	$159.21
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.18 / $122.54 / $176.34	Professional		$104.18	$122.54	$176.34
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.33 / $38.04 / $95.26	Professional	26	$32.33	$38.04	$95.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.63 / $83.62 / $126.54	Professional	TC	$67.63	$83.62	$126.54
United Facility/Professional Professional Modifier Low / Median / High Price $80.56 / $122.34 / $220.88	Professional		$80.56	$122.34	$220.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.54 / $41.50 / $68.15	Professional	26	$26.54	$41.50	$68.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.74 / $83.80 / $152.94	Professional	TC	$57.74	$83.80	$152.94