Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.98 / $25.98 / $79.89	Facility	26	$25.98	$25.98	$79.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.89 / $103.14 / $320.05	Professional		$70.89	$103.14	$320.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.91 / $31.12 / $120.91	Professional	26	$25.91	$31.12	$120.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.01 / $75.61 / $136.65	Professional	TC	$44.01	$75.61	$136.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $68.52 / $100.37	Professional		$43.00	$68.52	$100.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.37 / $25.62 / $61.67	Professional	26	$22.37	$25.62	$61.67
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $117.50 / $200.14	Professional		$31.36	$117.50	$200.14
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $34.93 / $44.45 / $79.26	Professional	26	$34.93	$44.45	$79.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $118.00 / $218.52	Professional		$74.84	$118.00	$218.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $40.53 / $66.56	Professional	26	$22.17	$40.53	$66.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.49 / $76.79 / $155.97	Professional	TC	$47.49	$76.79	$155.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.41 / $138.61 / $237.97	Professional		$114.41	$138.61	$237.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $39.69 / $68.29	Professional	26	$32.83	$39.69	$68.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.58 / $98.93 / $169.69	Professional	TC	$81.58	$98.93	$169.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.16 / $104.14 / $163.71	Professional		$73.16	$104.14	$163.71
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $30.48 / $104.91	Professional	26	$25.30	$30.48	$104.91
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.19 / $76.89 / $114.41	Professional	TC	$62.19	$76.89	$114.41
United Facility/Professional Professional Modifier Low / Median / High Price $74.17 / $112.56 / $183.30	Professional		$74.17	$112.56	$183.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $35.14 / $57.83	Professional	26	$22.23	$35.14	$57.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.77 / $81.75 / $142.34	Professional	TC	$51.77	$81.75	$142.34