Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.69 / $94.24 / $609.61	Facility		$30.69	$94.24	$609.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.56 / $12.56 / $61.56	Facility	26	$12.56	$12.56	$61.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.53 / $36.20 / $62.12	Professional		$25.53	$36.20	$62.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $13.80 / $27.71	Professional	26	$10.89	$13.80	$27.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.94 / $21.98 / $36.54	Professional	TC	$16.94	$21.98	$36.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $38.21 / $42.98	Professional		$27.29	$38.21	$42.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $11.60 / $28.33	Professional	26	$9.59	$11.60	$28.33
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $675.57 / $1,368.34 / $1,821.90	Facility		$675.57	$1,368.34	$1,821.90
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $23.79 / $42.00	Professional		$14.40	$23.79	$42.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $15.75 / $21.69 / $42.40	Professional	26	$15.75	$21.69	$42.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.46 / $76.42 / $88.93	Facility		$61.46	$76.42	$88.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.20 / $47.06 / $80.20	Professional		$28.20	$47.06	$80.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.85 / $31.68	Professional	26	$9.77	$18.85	$31.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $27.52 / $45.06	Professional	TC	$16.78	$27.52	$45.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38.68 / $44.79 / $72.63	Professional		$38.68	$44.79	$72.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $17.54 / $30.53	Professional	26	$13.14	$17.54	$30.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $35.49 / $61.03	Professional	TC	$25.54	$35.49	$61.03
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.69 / $31.42 / $48.95	Professional		$19.69	$31.42	$48.95
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.47 / $13.49 / $34.09	Professional	26	$11.47	$13.49	$34.09
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $23.17 / $37.56	Professional	TC	$18.73	$23.17	$37.56
United Facility/Professional Professional Modifier Low / Median / High Price $27.51 / $37.17 / $66.56	Professional		$27.51	$37.17	$66.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $15.51 / $26.18	Professional	26	$9.68	$15.51	$26.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $23.49 / $44.96	Professional	TC	$17.55	$23.49	$44.96