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 / $140.44	Facility	26	$27.98	$27.98	$140.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.66 / $129.36 / $232.84	Professional		$98.66	$129.36	$232.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.98 / $37.63 / $64.50	Professional	26	$27.98	$37.63	$64.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.39 / $89.70 / $142.47	Professional	TC	$72.39	$89.70	$142.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.57 / $107.65 / $128.93	Professional		$93.57	$107.65	$128.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.59 / $37.13 / $69.68	Professional	26	$32.59	$37.13	$69.68
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $273.60 / $273.60	Professional		$74.37	$273.60	$273.60
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 $100.25 / $146.32 / $254.48	Professional		$100.25	$146.32	$254.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $45.03 / $77.41	Professional	26	$29.86	$45.03	$77.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.56 / $106.63 / $192.08	Professional	TC	$66.56	$106.63	$192.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $147.35 / $186.54 / $257.37	Professional		$147.35	$186.54	$257.37
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.48 / $55.55 / $75.73	Professional	26	$47.48	$55.55	$75.73
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.43 / $134.05 / $181.63	Professional	TC	$111.43	$134.05	$181.63
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.08 / $135.38 / $181.13	Professional		$115.08	$135.38	$181.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $42.33 / $95.26	Professional	26	$35.97	$42.33	$95.26
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.09 / $93.06 / $139.57	Professional	TC	$79.09	$93.06	$139.57
United Facility/Professional Professional Modifier Low / Median / High Price $89.01 / $134.25 / $239.28	Professional		$89.01	$134.25	$239.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.69 / $46.19 / $72.42	Professional	26	$26.69	$46.19	$72.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.90 / $101.65 / $180.51	Professional	TC	$65.90	$101.65	$180.51