Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.57 / $6.57 / $33.00	Facility	26	$6.57	$6.57	$33.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.34 / $26.40 / $54.32	Professional		$16.34	$26.40	$54.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.57 / $12.10 / $22.96	Professional	26	$6.57	$12.10	$22.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.64 / $16.53 / $28.83	Professional	TC	$9.64	$16.53	$28.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.71 / $30.71 / $30.71	Professional		$30.71	$30.71	$30.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $14.10 / $27.88	Professional	26	$11.70	$14.10	$27.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $27.26 / $42.40 / $84.15	Professional		$27.26	$42.40	$84.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.27 / $5.27 / $5.27	Facility	26	$5.27	$5.27	$5.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $28.71 / $56.44	Professional		$16.89	$28.71	$56.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $11.45 / $21.04	Professional	26	$7.58	$11.45	$21.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.24 / $18.18 / $36.44	Professional	TC	$9.24	$18.18	$36.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.12 / $55.56 / $81.53	Professional		$26.12	$55.56	$81.53
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $19.86 / $27.34	Professional	26	$17.09	$19.86	$27.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $39.75 / $54.19	Professional	TC	$33.11	$39.75	$54.19
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.19 / $37.03 / $49.23	Professional		$21.19	$37.03	$49.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.66 / $14.89 / $25.02	Professional	26	$12.66	$14.89	$25.02
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.95 / $39.92	Professional	TC	$22.91	$26.95	$39.92
United Facility/Professional Professional Modifier Low / Median / High Price $19.89 / $39.90 / $72.62	Professional		$19.89	$39.90	$72.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $15.41 / $26.68	Professional	26	$7.59	$15.41	$26.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.47 / $26.33 / $47.20	Professional	TC	$12.47	$26.33	$47.20