Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $181.97 / $288.40	Facility	26	$41.69	$181.97	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $165.96	Professional		$54.95	$66.07	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $47.86 / $128.82	Professional	26	$38.02	$47.86	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $48.98	Professional	TC	$15.14	$19.95	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $69.18	Professional		$50.12	$50.12	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	26	$43.65	$43.65	$43.65
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $70.79	Professional		$48.98	$48.98	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $147.91	Professional		$56.23	$81.28	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $56.23 / $100.00	Professional	26	$38.02	$56.23	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $24.55 / $45.71	Professional	TC	$15.85	$24.55	$45.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $91.20	Professional		$77.62	$87.10	$91.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $63.10	Professional	26	$53.70	$61.66	$63.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.30 / $28.18	Professional	TC	$23.44	$26.30	$28.18
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $120.23	Professional		$38.02	$64.57	$120.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $57.54 / $95.50	Professional	26	$40.74	$57.54	$95.50
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.91 / $40.74	Professional	TC	$16.60	$22.91	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $131.83	Professional		$48.98	$72.44	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $91.20	Professional	26	$33.88	$50.12	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $21.88 / $40.74	Professional	TC	$14.79	$21.88	$40.74