Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.70 / $73.44 / $206.80	Professional		$51.70	$73.44	$206.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $32.78 / $231.20	Professional	26	$17.05	$32.78	$231.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $48.05 / $176.76	Professional	TC	$29.46	$48.05	$176.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $53.78 / $89.33	Professional		$53.78	$53.78	$89.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.06 / $29.08 / $46.53	Professional	26	$26.06	$29.08	$46.53
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $37.64 / $93.78 / $123.00	Professional		$37.64	$93.78	$123.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $72.15 / $139.97	Professional		$38.84	$72.15	$139.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $22.38 / $45.17	Professional	26	$11.81	$22.38	$45.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.03 / $50.17 / $97.56	Professional	TC	$27.03	$50.17	$97.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $102.36 / $144.90	Professional		$71.65	$102.36	$144.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $30.72 / $39.50	Professional	26	$19.80	$30.72	$39.50
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.84 / $74.05 / $105.39	Professional	TC	$51.84	$74.05	$105.39
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.18 / $78.97 / $139.07	Professional		$62.18	$78.97	$139.07
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.16 / $23.14 / $59.50	Professional	26	$19.16	$23.14	$59.50
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.74 / $55.26 / $98.01	Professional	TC	$45.74	$55.26	$98.01
United Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $76.70 / $116.91	Professional		$37.40	$76.70	$116.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.21 / $24.02 / $35.54	Professional	26	$12.21	$24.02	$35.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.32 / $51.27 / $90.44	Professional	TC	$29.32	$51.27	$90.44