Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.67 / $27.67 / $143.41	Facility	26	$27.67	$27.67	$143.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.69 / $80.50 / $120.59	Professional		$64.69	$80.50	$120.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $32.52 / $47.08	Professional	26	$26.53	$32.52	$47.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $47.97 / $62.76	Professional	TC	$38.15	$47.97	$62.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $31.49 / $67.73	Professional	26	$25.71	$31.49	$67.73
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $59.87 / $162.13	Professional		$57.89	$59.87	$162.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.19 / $105.18 / $168.79	Professional		$63.19	$105.18	$168.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.82 / $41.91 / $69.40	Professional	26	$23.82	$41.91	$69.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.32 / $62.59 / $103.18	Professional	TC	$38.32	$62.59	$103.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.59 / $112.29 / $153.12	Professional		$91.59	$112.29	$153.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $43.63 / $59.88	Professional	26	$37.47	$43.63	$59.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.12 / $68.65 / $93.24	Professional	TC	$57.12	$68.65	$93.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $80.05 / $126.21	Professional		$57.89	$80.05	$126.21
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.85 / $33.57 / $69.70	Professional	26	$27.85	$33.57	$69.70
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.19 / $49.69 / $82.00	Professional	TC	$40.19	$49.69	$82.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $91.59 / $150.91	Professional		$62.14	$91.59	$150.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $37.84 / $60.74	Professional	26	$24.09	$37.84	$60.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.57 / $52.80 / $91.20	Professional	TC	$37.57	$52.80	$91.20