Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.22 / $15.22 / $69.01	Facility	26	$15.22	$15.22	$69.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.97 / $43.52 / $61.34	Professional		$29.97	$43.52	$61.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $15.22 / $20.25	Professional	26	$12.26	$15.22	$20.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $27.94 / $41.09	Professional	TC	$18.85	$27.94	$41.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.18 / $72.18 / $72.18	Professional		$72.18	$72.18	$72.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $12.10 / $12.10	Professional	26	$12.10	$12.10	$12.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $55.61 / $88.67	Professional		$33.61	$55.61	$88.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.84 / $19.57 / $32.92	Professional	26	$11.84	$19.57	$32.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $35.85 / $58.12	Professional	TC	$21.88	$35.85	$58.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.53 / $64.26 / $87.78	Professional		$48.53	$64.26	$87.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.61 / $21.66 / $29.77	Professional	26	$18.61	$21.66	$29.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $42.59 / $58.01	Professional	TC	$35.47	$42.59	$58.01
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $37.93 / $81.67	Professional		$25.34	$37.93	$81.67
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.64 / $42.03	Professional	26	$13.80	$16.64	$42.03
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.38 / $39.50 / $46.47	Professional	TC	$28.38	$39.50	$46.47
United Facility/Professional Professional Modifier Low / Median / High Price $33.51 / $49.10 / $81.30	Professional		$33.51	$49.10	$81.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.85 / $18.00 / $29.14	Professional	26	$11.85	$18.00	$29.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $31.77 / $52.16	Professional	TC	$21.02	$31.77	$52.16