Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $125.89	Professional		$89.13	$93.33	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $41.69 / $77.62	Professional	26	$33.88	$41.69	$77.62
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $169.82 / $269.15	Professional		$47.86	$169.82	$269.15
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $245.47	Professional		$102.33	$125.89	$245.47
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $43.65 / $91.20	Professional	26	$37.15	$43.65	$91.20
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $81.28 / $177.83	Professional	TC	$69.18	$81.28	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $263.03	Professional		$97.72	$151.36	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $48.98 / $83.18	Professional	26	$33.11	$48.98	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $107.15 / $173.78	Professional	TC	$61.66	$107.15	$173.78