Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.13 / $38.90	Professional		$10.00	$14.13	$38.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $5.62 / $18.20	Professional	26	$2.95	$5.62	$18.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $10.00 / $26.92	Professional	TC	$6.92	$10.00	$26.92
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $10.00 / $29.51	Professional		$6.03	$10.00	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $13.80 / $30.90	Professional		$8.91	$13.80	$30.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.29 / $4.47 / $9.33	Professional	26	$2.29	$4.47	$9.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $11.48 / $24.55	Professional	TC	$6.31	$11.48	$24.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $20.42 / $35.48	Professional		$12.59	$20.42	$35.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $5.25 / $10.72	Professional	26	$3.24	$5.25	$10.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $15.14 / $25.12	Professional	TC	$9.33	$15.14	$25.12
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $13,803.84 / $19,498.45	Facility		$562.34	$13,803.84	$19,498.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.49 / $41.69	Professional		$10.96	$15.49	$41.69
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $4.68 / $8.32	Professional	26	$3.02	$4.68	$8.32
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $13.80 / $31.62	Professional	TC	$7.94	$13.80	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $13.18 / $25.12	Professional		$8.13	$13.18	$25.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.09 / $3.63 / $6.31	Professional	26	$2.09	$3.63	$6.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $10.00 / $20.42	Professional	TC	$6.03	$10.00	$20.42