Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.59 / $10.30 / $127.29	Facility		$9.59	$10.30	$127.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.16 / $7.16 / $40.53	Facility	26	$7.16	$7.16	$40.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $12.15 / $26.19	Professional		$10.19	$12.15	$26.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $8.25 / $14.47	Professional	26	$6.90	$8.25	$14.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $11.36 / $11.36	Professional	50	$11.36	$11.36	$11.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.15 / $3.89 / $6.73	Professional	TC	$3.15	$3.89	$6.73
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $15.50 / $15.50	Professional		$15.50	$15.50	$15.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8.96 / $11.26 / $17.17	Facility		$8.96	$11.26	$17.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.52 / $17.67 / $31.01	Professional		$9.52	$17.67	$31.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $11.69 / $19.59	Professional	26	$5.63	$11.69	$19.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.62 / $5.14 / $10.22	Professional	TC	$2.62	$5.14	$10.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $15.39 / $27.14	Professional		$13.05	$15.39	$27.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $10.23 / $17.78	Professional	26	$8.55	$10.23	$17.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.38 / $5.15 / $9.36	Professional	TC	$4.38	$5.15	$9.36
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.63 / $59.55 / $120.90	Facility		$49.63	$59.55	$120.90
Horizon BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $48.05 / $48.05 / $48.05	Facility	26	$48.05	$48.05	$48.05
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.73 / $8.40 / $15.58	Professional		$4.73	$8.40	$15.58
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.70 / $9.78 / $13.79	Professional	26	$6.70	$9.78	$13.79
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.43 / $4.04 / $6.80	Professional	TC	$3.43	$4.04	$6.80
United Facility/Professional Facility Modifier Low / Median / High Price $34.49 / $47.25 / $103.01	Facility		$34.49	$47.25	$103.01
United Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $12.82 / $22.61	Professional		$8.50	$12.82	$22.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.60 / $8.99 / $14.95	Professional	26	$5.60	$8.99	$14.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.79 / $4.23 / $7.92	Professional	TC	$2.79	$4.23	$7.92