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 / $71.48	Facility	26	$14.85	$14.86	$71.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $118.50 / $188.91	Professional		$68.75	$118.50	$188.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.86 / $24.17 / $52.09	Professional	26	$14.86	$24.17	$52.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.02 / $84.68 / $174.04	Professional	TC	$42.02	$84.68	$174.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.27 / $68.27 / $68.27	Professional		$68.27	$68.27	$68.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.60 / $36.72 / $69.00	Professional	26	$35.60	$36.72	$69.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $159.75 / $159.75	Professional		$49.03	$159.75	$159.75
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 $74.13 / $151.94 / $559.99	Professional		$74.13	$151.94	$559.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $28.85 / $63.56	Professional	26	$17.55	$28.85	$63.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.70 / $112.32 / $527.72	Professional	TC	$40.70	$112.32	$527.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $131.13 / $527.85	Professional		$111.25	$131.13	$527.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.56 / $59.64 / $82.48	Professional	26	$51.56	$59.64	$82.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.48 / $71.50 / $97.09	Professional	TC	$59.48	$71.50	$97.09
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.10 / $102.23 / $181.67	Professional		$50.10	$102.23	$181.67
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.51 / $45.30 / $72.05	Professional	26	$38.51	$45.30	$72.05
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.65 / $61.94 / $183.92	Professional	TC	$52.65	$61.94	$183.92
United Facility/Professional Professional Modifier Low / Median / High Price $72.43 / $131.65 / $414.12	Professional		$72.43	$131.65	$414.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $44.26 / $77.28	Professional	26	$16.57	$44.26	$77.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.13 / $71.89 / $186.04	Professional	TC	$39.13	$71.89	$186.04