Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $61.66 / $100.00	Professional		$46.77	$61.66	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $35.48	Professional	26	$19.05	$25.70	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $60.26	Professional	TC	$25.70	$33.88	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $69.18 / $69.18	Professional		$67.61	$69.18	$69.18
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $169.82	Professional		$61.66	$77.62	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $75.86 / $147.91	Professional		$39.81	$75.86	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $30.20 / $58.88	Professional	26	$15.85	$30.20	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $48.98 / $87.10	Professional	TC	$23.44	$48.98	$87.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $97.72	Professional		$44.67	$56.23	$97.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $39.81	Professional	26	$30.90	$30.90	$39.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $46.77 / $58.88	Professional	TC	$44.67	$46.77	$58.88
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $263.03 / $295.12	Facility		$251.19	$263.03	$295.12
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $63.10 / $125.89	Professional		$42.66	$63.10	$125.89
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $28.18 / $52.48	Professional	26	$22.39	$28.18	$52.48
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.90 / $97.72	Professional	TC	$33.11	$38.90	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.86 / $91.20	Professional		$36.31	$47.86	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.62 / $40.74	Professional	26	$14.79	$18.62	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $57.54	Professional	TC	$21.38	$28.84	$57.54