Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.68 / $15.69 / $86.40	Facility	26	$15.68	$15.69	$86.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.35 / $43.96 / $151.47	Professional		$26.35	$43.96	$151.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.69 / $24.37 / $69.09	Professional	26	$15.69	$24.37	$69.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.17 / $17.17 / $17.17	Professional	50	$17.17	$17.17	$17.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.77 / $11.55 / $36.79	Professional	TC	$8.77	$11.55	$36.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.10 / $46.45 / $63.30	Professional		$30.10	$46.45	$63.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $26.28 / $40.56	Professional	26	$22.26	$26.28	$40.56
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $81.11 / $146.69	Professional		$39.79	$81.11	$146.69
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $37.89 / $48.12 / $72.20	Professional	26	$37.89	$48.12	$72.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $49.70 / $92.44	Professional		$30.33	$49.70	$92.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $30.85 / $53.82	Professional	26	$16.72	$30.85	$53.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.27 / $17.20 / $44.12	Professional	TC	$9.27	$17.20	$44.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $76.70 / $151.94	Professional		$39.22	$76.70	$151.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $43.20 / $74.78	Professional	26	$35.95	$43.20	$74.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.10 / $44.96 / $77.17	Professional	TC	$37.10	$44.96	$77.17
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.06 / $49.05 / $82.19	Professional		$22.06	$49.05	$82.19
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $22.87 / $44.27	Professional	26	$19.41	$22.87	$44.27
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $32.64 / $48.13	Professional	TC	$19.82	$32.64	$48.13
United Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $56.96 / $98.50	Professional		$27.55	$56.96	$98.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $24.42 / $44.39	Professional	26	$17.76	$24.42	$44.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.92 / $29.64 / $58.55	Professional	TC	$9.92	$29.64	$58.55