Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $31.62 / $151.36	Facility	26	$15.85	$31.62	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $81.28 / $309.03	Professional		$38.90	$81.28	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $33.11 / $79.43	Professional	26	$18.20	$33.11	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $33.88 / $100.00	Professional	TC	$18.20	$33.88	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $64.57	Professional		$26.92	$41.69	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.39 / $43.65	Professional	26	$18.20	$22.39	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	TC	$25.12	$25.12	$25.12
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $53.70 / $131.83	Professional		$25.12	$53.70	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $81.28 / $154.88	Professional		$42.66	$81.28	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $27.54 / $47.86	Professional	26	$17.38	$27.54	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $46.77 / $112.20	Professional	TC	$20.89	$46.77	$112.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $69.18 / $107.15	Professional		$60.26	$69.18	$107.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.18 / $38.90	Professional	26	$26.92	$28.18	$38.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $34.67 / $47.86	Professional	TC	$33.11	$34.67	$47.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $117.49	Professional		$30.90	$51.29	$117.49
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $43.65	Professional	26	$19.95	$23.99	$43.65
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $74.13	Professional	TC	$21.38	$28.84	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $114.82	Professional		$38.02	$61.66	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $23.99 / $42.66	Professional	26	$15.85	$23.99	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.90 / $87.10	Professional	TC	$20.42	$30.90	$87.10