Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $16.98 / $45.71	Professional		$12.88	$16.98	$45.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $25.70 / $79.43	Professional	26	$8.32	$25.70	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $7.08 / $20.89	Professional	TC	$5.01	$7.08	$20.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $22.91 / $109.65	Professional		$14.13	$22.91	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $16.98 / $31.62	Professional		$10.00	$16.98	$31.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $12.59 / $21.38	Professional	26	$6.31	$12.59	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $5.75 / $12.59	Professional	TC	$3.72	$5.75	$12.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $23.44 / $34.67	Professional		$14.79	$23.44	$34.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $13.18 / $16.98	Professional	26	$6.76	$13.18	$16.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.46 / $10.72 / $15.85	Professional	TC	$6.46	$10.72	$15.85
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $13,803.84 / $19,498.45	Facility		$380.19	$13,803.84	$19,498.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $15.85 / $38.02	Professional		$8.32	$15.85	$38.02
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $17.78 / $26.30	Professional	26	$9.12	$17.78	$26.30
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $9.33 / $19.05	Professional	TC	$6.31	$9.33	$19.05
United Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $15.85 / $30.20	Professional		$9.33	$15.85	$30.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $10.00 / $17.78	Professional	26	$5.62	$10.00	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $6.76 / $12.59	Professional	TC	$3.72	$6.76	$12.59