Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.85 / $14.86 / $74.56	Facility	26	$14.85	$14.86	$74.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $130.99 / $274.16	Professional		$63.39	$130.99	$274.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.86 / $20.55 / $36.10	Professional	26	$14.86	$20.55	$36.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.26 / $23.23 / $49.25	Professional	26	$18.26	$23.23	$49.25
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $42.14 / $165.00	Professional		$42.14	$42.14	$165.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $25.77 / $25.77 / $30.11	Professional	26	$25.77	$25.77	$30.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $11.98 / $11.98	Facility	26	$11.98	$11.98	$11.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.54 / $132.53 / $229.32	Professional		$64.54	$132.53	$229.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.21 / $24.00 / $41.56	Professional	26	$16.21	$24.00	$41.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.15 / $108.45 / $150.04	Professional		$91.15	$108.45	$150.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $32.21 / $43.76	Professional	26	$27.46	$32.21	$43.76
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.85 / $75.12 / $214.90	Professional		$63.85	$75.12	$214.90
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $24.39 / $61.28	Professional	26	$20.23	$24.39	$61.28
United Facility/Professional Professional Modifier Low / Median / High Price $60.83 / $99.43 / $176.41	Professional		$60.83	$99.43	$176.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $25.98 / $45.36	Professional	26	$15.12	$25.98	$45.36