Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.13 / $13.13 / $63.00	Facility	26	$13.13	$13.13	$63.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.11 / $48.71 / $72.41	Professional		$29.11	$48.71	$72.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $14.39 / $23.21	Professional	26	$12.23	$14.39	$23.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.04 / $29.48 / $54.11	Professional	TC	$17.04	$29.48	$54.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $13.30 / $24.93	Professional	26	$11.72	$13.30	$24.93
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $26.42 / $26.42	Professional		$26.42	$26.42	$26.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.55 / $10.55 / $10.55	Facility	26	$10.55	$10.55	$10.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.16 / $58.78 / $107.95	Professional		$31.16	$58.78	$107.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $18.98 / $31.57	Professional	26	$10.73	$18.98	$31.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $38.04 / $77.36	Professional	TC	$19.72	$38.04	$77.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $57.19 / $78.23	Professional		$48.29	$57.19	$78.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $19.80 / $27.27	Professional	26	$17.05	$19.80	$27.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.15 / $37.38 / $50.97	Professional	TC	$31.15	$37.38	$50.97
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $34.52 / $62.06	Professional		$21.53	$34.52	$62.06
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $14.93 / $27.17	Professional	26	$12.67	$14.93	$27.17
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $25.33 / $64.34	Professional	TC	$20.49	$25.33	$64.34
United Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $49.30 / $86.19	Professional		$31.63	$49.30	$86.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $17.14 / $28.86	Professional	26	$11.16	$17.14	$28.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.47 / $31.97 / $60.76	Professional	TC	$20.47	$31.97	$60.76