Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $245.47	Professional		$63.10	$89.13	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $72.44 / $354.81	Professional	26	$25.12	$72.44	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $57.54 / $169.82	Professional	TC	$42.66	$57.54	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $57.54	Professional	26	$37.15	$46.77	$57.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	TC	$39.81	$39.81	$39.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $104.71 / $199.53	Professional		$36.31	$104.71	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $85.11 / $181.97	Professional		$53.70	$85.11	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $36.31 / $72.44	Professional	26	$19.50	$36.31	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $107.15	Professional	TC	$30.90	$45.71	$107.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $194.98	Professional		$70.79	$134.90	$194.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $38.02 / $75.86	Professional	26	$20.89	$38.02	$75.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $97.72 / $123.03	Professional	TC	$50.12	$97.72	$123.03
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $13,803.84 / $19,498.45	Facility		$446.68	$13,803.84	$19,498.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $199.53	Professional		$58.88	$91.20	$199.53
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $37.15 / $74.13	Professional	26	$23.99	$37.15	$74.13
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $89.13 / $141.25	Professional	TC	$50.12	$89.13	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $151.36	Professional		$50.12	$85.11	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $28.18 / $48.98	Professional	26	$16.22	$28.18	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $56.23 / $100.00	Professional	TC	$33.88	$56.23	$100.00