Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.17 / $22.18 / $93.25	Facility	26	$22.17	$22.18	$93.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.81 / $65.77 / $99.24	Professional		$49.81	$65.77	$99.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $20.37 / $26.17	Professional	26	$16.72	$20.37	$26.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.50 / $44.76 / $56.54	Professional	TC	$32.50	$44.76	$56.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $19.73 / $19.73	Professional	26	$19.73	$19.73	$19.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $80.31 / $132.60	Professional		$50.40	$80.31	$132.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.74 / $26.77 / $44.48	Professional	26	$14.74	$26.77	$44.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.86 / $53.30 / $90.56	Professional	TC	$33.86	$53.30	$90.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $90.79 / $123.50	Professional		$75.97	$90.79	$123.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $27.35 / $37.29	Professional	26	$23.37	$27.35	$37.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.79 / $63.44 / $86.20	Professional	TC	$52.79	$63.44	$86.20
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $54.64 / $104.49	Professional		$42.89	$54.64	$104.49
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $20.87 / $40.68	Professional	26	$17.73	$20.87	$40.68
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.70 / $40.82 / $72.23	Professional	TC	$34.70	$40.82	$72.23
United Facility/Professional Professional Modifier Low / Median / High Price $47.29 / $63.15 / $112.46	Professional		$47.29	$63.15	$112.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.10 / $24.00 / $39.71	Professional	26	$15.10	$24.00	$39.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.40 / $46.91 / $85.28	Professional	TC	$34.40	$46.91	$85.28