Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.16 / $13.16 / $61.93	Facility	26	$13.16	$13.16	$61.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $39.47 / $80.64	Professional		$30.55	$39.47	$80.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $13.37 / $20.84	Professional	26	$10.97	$13.37	$20.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.41 / $19.37 / $25.22	Professional	52	$14.41	$19.37	$25.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $25.56 / $39.47	Professional	TC	$20.53	$25.56	$39.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $29.41 / $39.69	Professional		$29.41	$29.41	$39.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.38 / $15.77 / $16.14	Professional	26	$12.38	$15.77	$16.14
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.20 / $14.20 / $14.20	Professional		$14.20	$14.20	$14.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $51.98 / $86.63	Professional		$32.70	$51.98	$86.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $16.70 / $28.67	Professional	26	$9.52	$16.70	$28.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $32.24 / $53.44	Professional	TC	$19.85	$32.24	$53.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $58.72 / $86.36	Professional		$45.12	$58.72	$86.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.89 / $17.23 / $23.86	Professional	26	$14.89	$17.23	$23.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $45.91 / $62.50	Professional	TC	$38.22	$45.91	$62.50
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $43.07 / $68.03	Professional		$36.42	$43.07	$68.03
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $12.91 / $34.54	Professional	26	$10.97	$12.91	$34.54
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $30.96 / $51.64	Professional	TC	$25.63	$30.96	$51.64
United Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $44.64 / $78.59	Professional		$29.64	$44.64	$78.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $15.46 / $25.05	Professional	26	$9.52	$15.46	$25.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.52 / $32.22 / $55.44	Professional	TC	$22.52	$32.22	$55.44