Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.24 / $59.80 / $97.87	Professional		$47.24	$59.80	$97.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $27.62 / $117.30	Professional	26	$17.30	$27.62	$117.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $38.14 / $50.10	Professional	TC	$27.69	$38.14	$50.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $37.46 / $63.04	Professional		$37.46	$37.46	$63.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $44.82 / $44.82	Professional	26	$44.82	$44.82	$44.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $40.92 / $97.20 / $246.35	Professional		$40.92	$97.20	$246.35
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $113.19 / $113.19 / $113.19	Professional	26	$113.19	$113.19	$113.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $65.81 / $174.84	Professional		$36.79	$65.81	$174.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.32 / $30.95 / $99.95	Professional	26	$15.32	$30.95	$99.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $38.33 / $85.30	Professional	TC	$21.33	$38.33	$85.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.15 / $71.64 / $107.34	Professional		$50.15	$71.64	$107.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $29.93 / $50.27	Professional	26	$19.30	$29.93	$50.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $48.88 / $75.14	Professional	TC	$30.84	$48.88	$75.14
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $54.94 / $125.53	Professional		$39.89	$54.94	$125.53
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $21.94 / $80.66	Professional	26	$18.64	$21.94	$80.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.06 / $35.32 / $78.48	Professional	TC	$28.06	$35.32	$78.48
United Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $63.34 / $102.86	Professional		$33.97	$63.34	$102.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $25.03 / $45.32	Professional	26	$12.75	$25.03	$45.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.52 / $33.14 / $58.93	Professional	TC	$20.52	$33.14	$58.93