Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.96 / $21.96 / $110.24	Facility	26	$21.96	$21.96	$110.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $75.61 / $195.96	Professional		$52.83	$75.61	$195.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $26.13 / $60.51	Professional	26	$20.78	$26.13	$60.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.68 / $36.45 / $97.25	Professional	52	$25.68	$36.45	$97.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.59 / $50.92 / $91.93	Professional	TC	$26.59	$50.92	$91.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.03 / $46.63 / $56.68	Professional		$35.03	$46.63	$56.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $21.03 / $32.88	Professional	26	$5.04	$21.03	$32.88
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.76 / $10.13 / $40.03	Professional	52	$8.76	$10.13	$40.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $29.40 / $29.40 / $125.58	Professional		$29.40	$29.40	$125.58
AmeriHealth Facility/Professional Professional Modifier 52 Low / Median / High Price $100.46 / $100.46 / $100.46	Professional	52	$100.46	$100.46	$100.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $102.43 / $170.83	Professional		$52.38	$102.43	$170.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $35.04 / $57.64	Professional	26	$19.88	$35.04	$57.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.68 / $67.48 / $116.73	Professional	TC	$28.68	$67.48	$116.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $86.85 / $137.03	Professional		$65.88	$86.85	$137.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.55 / $35.64 / $61.46	Professional	26	$29.55	$35.64	$61.46
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.33 / $44.01 / $75.56	Professional	TC	$36.33	$44.01	$75.56
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.47 / $77.14 / $130.47	Professional		$60.47	$77.14	$130.47
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.02 / $27.73 / $78.28	Professional	26	$23.02	$27.73	$78.28
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $51.40 / $83.78	Professional	TC	$42.55	$51.40	$83.78
United Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $78.48 / $152.38	Professional		$43.98	$78.48	$152.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $30.86 / $52.59	Professional	26	$19.82	$30.86	$52.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $57.53 / $104.05	Professional	TC	$24.30	$57.53	$104.05