Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.25 / $33.25 / $160.57	Facility	26	$33.25	$33.25	$160.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.50 / $92.40 / $171.00	Professional		$70.50	$92.40	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.25 / $39.02 / $70.53	Professional	26	$33.25	$39.02	$70.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $49.65 / $104.85	Professional	TC	$32.72	$49.65	$104.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.95 / $54.80 / $72.31	Professional		$47.95	$54.80	$72.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $35.18 / $61.99	Professional	26	$28.35	$35.18	$61.99
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $40.69 / $79.17 / $184.50	Professional		$40.69	$79.17	$184.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.58 / $27.58 / $27.58	Facility	26	$27.58	$27.58	$27.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $117.05 / $222.84	Professional		$57.90	$117.05	$222.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.77 / $47.68 / $79.18	Professional	26	$26.77	$47.68	$79.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.94 / $60.04 / $158.27	Professional	TC	$26.94	$60.04	$158.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $92.32 / $108.99 / $187.84	Professional		$92.32	$108.99	$187.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $49.40 / $67.55	Professional	26	$42.32	$49.40	$67.55
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.70 / $59.60 / $81.45	Professional	TC	$49.70	$59.60	$81.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.45 / $69.28 / $115.92	Professional		$45.45	$69.28	$115.92
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $37.35 / $56.02	Professional	26	$31.75	$37.35	$56.02
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $31.93 / $56.33	Professional	TC	$27.14	$31.93	$56.33
United Facility/Professional Professional Modifier Low / Median / High Price $63.44 / $95.27 / $166.92	Professional		$63.44	$95.27	$166.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $44.67 / $71.63	Professional	26	$31.43	$44.67	$71.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.69 / $47.67 / $105.15	Professional	TC	$29.69	$47.67	$105.15