Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $51.29 / $239.88	Facility	26	$28.18	$51.29	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $363.08	Professional		$89.13	$131.83	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $54.95 / $128.82	Professional	26	$30.20	$54.95	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $87.10 / $190.55	Professional	TC	$61.66	$87.10	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $117.49	Professional		$109.65	$109.65	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $36.31 / $70.79	Professional	26	$28.84	$36.31	$70.79
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $69.18	Professional		$51.29	$66.07	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $22.91	Facility	26	$22.91	$22.91	$22.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $239.88	Professional		$91.20	$134.90	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $43.65 / $77.62	Professional	26	$27.54	$43.65	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $91.20 / $165.96	Professional	TC	$57.54	$91.20	$165.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $234.42	Professional		$144.54	$173.78	$234.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $51.29 / $70.79	Professional	26	$44.67	$51.29	$70.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $123.03 / $165.96	Professional	TC	$102.33	$123.03	$165.96
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $239.88	Professional		$104.71	$123.03	$239.88
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.90 / $72.44	Professional	26	$33.11	$38.90	$72.44
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $83.18 / $181.97	Professional	TC	$70.79	$83.18	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $213.80	Professional		$81.28	$123.03	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $39.81 / $67.61	Professional	26	$26.30	$39.81	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $83.18 / $154.88	Professional	TC	$54.95	$83.18	$154.88