Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.82 / $41.82 / $180.94	Facility	26	$41.82	$41.82	$180.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $61.78 / $82.22	Professional		$53.06	$61.78	$82.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $42.40 / $56.03	Professional	26	$37.99	$42.40	$56.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.76 / $19.94 / $28.80	Professional	TC	$16.76	$19.94	$28.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $36.81 / $36.81	Professional	26	$36.81	$36.81	$36.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $48.72 / $71.14	Professional		$48.72	$48.72	$71.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.31 / $81.39 / $144.94	Professional		$54.31	$81.39	$144.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.06 / $55.60 / $98.98	Professional	26	$38.06	$55.60	$98.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.02 / $24.93 / $45.35	Professional	TC	$16.02	$24.93	$45.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $89.28 / $89.28	Professional		$75.95	$89.28	$89.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.08 / $61.84 / $61.84	Professional	26	$53.08	$61.84	$61.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.88 / $27.43 / $27.43	Professional	TC	$22.88	$27.43	$27.43
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.06 / $50.27 / $85.66	Professional		$28.06	$50.27	$85.66
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $45.48 / $75.98	Professional	26	$30.83	$45.48	$75.98
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.96 / $19.72 / $32.58	Professional	TC	$15.96	$19.72	$32.58
United Facility/Professional Professional Modifier Low / Median / High Price $49.71 / $73.04 / $125.48	Professional		$49.71	$73.04	$125.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.64 / $52.28 / $87.10	Professional	26	$33.64	$52.28	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.18 / $22.94 / $38.88	Professional	TC	$15.18	$22.94	$38.88