Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $91.20 / $165.96	Facility	26	$25.70	$91.20	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $74.13 / $162.18	Professional		$34.67	$74.13	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.11 / $93.33	Professional	26	$20.89	$33.11	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $43.65 / $95.50	Professional	TC	$12.88	$43.65	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $53.70	Professional		$46.77	$46.77	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $22.39 / $23.99	Professional	26	$20.42	$22.39	$23.99
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $46.77 / $141.25	Professional		$25.12	$46.77	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $87.10 / $154.88	Professional		$34.67	$87.10	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.90 / $53.70	Professional	26	$20.42	$30.90	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $52.48 / $104.71	Professional	TC	$13.80	$52.48	$104.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $57.54	Professional		$47.86	$54.95	$57.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $31.62 / $32.36	Professional	26	$27.54	$31.62	$32.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $23.44 / $24.55	Professional	TC	$20.42	$23.44	$24.55
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $54.95 / $151.36	Professional		$26.92	$54.95	$151.36
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $34.67 / $52.48	Professional	26	$19.50	$34.67	$52.48
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $102.33	Professional	TC	$20.89	$28.18	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $61.66 / $114.82	Professional		$32.36	$61.66	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $27.54 / $48.98	Professional	26	$18.20	$27.54	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $33.88 / $69.18	Professional	TC	$13.80	$33.88	$69.18