Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.71 / $29.71 / $88.08	Facility	26	$29.71	$29.71	$88.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.47 / $68.76 / $116.52	Professional		$59.47	$68.76	$116.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.07 / $31.41 / $79.59	Professional	26	$27.07	$31.41	$79.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.44 / $40.02 / $57.94	Professional	TC	$29.44	$40.02	$57.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.17 / $49.17 / $52.11	Professional		$49.17	$49.17	$52.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.23 / $34.29 / $56.37	Professional	26	$26.23	$34.29	$56.37
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $143.04 / $278.25	Professional		$34.59	$143.04	$278.25
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $54.12 / $77.98	Professional	26	$28.37	$54.12	$77.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.72 / $88.29 / $153.50	Professional		$55.72	$88.29	$153.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.03 / $39.72 / $70.70	Professional	26	$27.03	$39.72	$70.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.61 / $48.17 / $91.55	Professional	TC	$30.61	$48.17	$91.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $78.40 / $92.79 / $92.79	Professional		$78.40	$92.79	$92.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.81 / $44.04 / $44.04	Professional	26	$37.81	$44.04	$44.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.59 / $48.75 / $48.75	Professional	TC	$40.59	$48.75	$48.75
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $65.06 / $112.68	Professional		$49.69	$65.06	$112.68
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.31 / $31.77 / $55.55	Professional	26	$26.31	$31.77	$55.55
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.11 / $35.42 / $62.44	Professional	TC	$30.11	$35.42	$62.44
United Facility/Professional Professional Modifier Low / Median / High Price $54.02 / $80.13 / $140.40	Professional		$54.02	$80.13	$140.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.87 / $36.47 / $64.23	Professional	26	$23.87	$36.47	$64.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.30 / $41.53 / $72.25	Professional	TC	$27.30	$41.53	$72.25