Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $79.43 / $117.49	Facility	26	$44.67	$79.43	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $134.90	Professional		$30.90	$45.71	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $18.20 / $58.88	Professional	26	$12.88	$18.20	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $69.18	Professional	TC	$19.95	$28.84	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $40.74	Professional		$35.48	$35.48	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Professional	26	$17.38	$17.38	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $93.33	Professional		$33.88	$54.95	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $19.95 / $34.67	Professional	26	$12.30	$19.95	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $35.48 / $60.26	Professional	TC	$21.88	$35.48	$60.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $91.20	Professional		$38.02	$64.57	$91.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.39 / $30.90	Professional	26	$19.05	$22.39	$30.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $44.67 / $61.66	Professional	TC	$37.15	$44.67	$61.66
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $53.70 / $89.13	Professional		$38.02	$53.70	$89.13
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.60 / $35.48	Professional	26	$14.13	$16.60	$35.48
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.88 / $53.70	Professional	TC	$25.12	$33.88	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $79.43	Professional		$33.11	$48.98	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $17.78 / $29.51	Professional	26	$11.22	$17.78	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.90 / $52.48	Professional	TC	$21.38	$30.90	$52.48