Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $70.56 / $115.30	Professional		$43.68	$70.56	$115.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $13.81 / $60.80	Professional	26	$8.41	$13.81	$60.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.94 / $61.83 / $129.96	Professional	TC	$38.94	$61.83	$129.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.16 / $46.16 / $75.62	Professional		$46.16	$46.16	$75.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $16.04 / $19.80	Professional	26	$11.12	$16.04	$19.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.97 / $35.97 / $39.97	Professional	TC	$35.97	$35.97	$39.97
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $71.25 / $141.75	Professional		$12.72	$71.25	$141.75
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $23.17 / $23.17	Professional	26	$23.17	$23.17	$23.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $63.76 / $136.75	Professional		$38.36	$63.76	$136.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.33 / $12.34 / $23.40	Professional	26	$6.33	$12.34	$23.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.79 / $54.24 / $114.26	Professional	TC	$31.79	$54.24	$114.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.36 / $93.96 / $124.62	Professional		$61.36	$93.96	$124.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $13.21 / $22.06	Professional	26	$8.48	$13.21	$22.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.88 / $75.54 / $107.65	Professional	TC	$52.88	$75.54	$107.65
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.84 / $76.91 / $121.28	Professional		$53.84	$76.91	$121.28
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $10.83 / $37.22	Professional	26	$8.14	$10.83	$37.22
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.69 / $63.34 / $103.09	Professional	TC	$45.69	$63.34	$103.09
United Facility/Professional Professional Modifier Low / Median / High Price $29.11 / $61.78 / $113.10	Professional		$29.11	$61.78	$113.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.60 / $9.07 / $17.11	Professional	26	$5.60	$9.07	$17.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.69 / $58.14 / $95.37	Professional	TC	$31.69	$58.14	$95.37