Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.25 / $22.25 / $113.08	Facility	26	$22.25	$22.25	$113.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.22 / $86.21 / $187.81	Professional		$50.22	$86.21	$187.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $28.24 / $54.65	Professional	26	$22.71	$28.24	$54.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $63.49 / $128.09	Professional	TC	$22.74	$63.49	$128.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.81 / $66.19 / $66.19	Professional		$60.81	$66.19	$66.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $26.09 / $50.87	Professional	26	$20.23	$26.09	$50.87
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $120.79 / $120.79 / $147.21	Professional		$120.79	$120.79	$147.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.39 / $118.08 / $213.43	Professional		$74.39	$118.08	$213.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.72 / $33.89 / $56.99	Professional	26	$19.72	$33.89	$56.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.74 / $83.65 / $158.12	Professional	TC	$53.74	$83.65	$158.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $115.40 / $142.19 / $193.69	Professional		$115.40	$142.19	$193.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.99 / $36.15 / $49.48	Professional	26	$30.99	$36.15	$49.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.26 / $106.04 / $144.22	Professional	TC	$88.26	$106.04	$144.22
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $91.19 / $124.86	Professional		$27.13	$91.19	$124.86
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.05 / $27.77 / $75.45	Professional	26	$23.05	$27.77	$75.45
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.30 / $75.65 / $120.31	Professional	TC	$64.30	$75.65	$120.31
United Facility/Professional Professional Modifier Low / Median / High Price $79.62 / $117.11 / $199.98	Professional		$79.62	$117.11	$199.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.87 / $31.70 / $51.77	Professional	26	$21.87	$31.70	$51.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.36 / $84.93 / $151.66	Professional	TC	$59.36	$84.93	$151.66