Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $57.54 / $239.88	Facility		$43.65	$57.54	$239.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.50 / $7.08 / $223.87	Facility	26	$5.50	$7.08	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.20 / $83.18	Professional		$18.20	$30.20	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.02 / $17.38	Professional	26	$2.00	$3.02	$17.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.74 / $40.74 / $41.69	Professional	52	$40.74	$40.74	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $51.29	Professional	TC	$15.14	$21.88	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $20.42 / $21.88	Professional		$19.50	$20.42	$21.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $5.75 / $5.75	Professional	26	$5.75	$5.75	$5.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $44.67 / $63.10	Facility		$22.91	$44.67	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $11.22 / $11.22	Facility	26	$11.22	$11.22	$11.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $35.48 / $61.66	Professional		$17.78	$35.48	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.45 / $4.90 / $12.59	Professional	26	$2.45	$4.90	$12.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $29.51 / $52.48	Professional	TC	$15.49	$29.51	$52.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $48.98	Professional		$28.84	$37.15	$48.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $4.68 / $6.17	Professional	26	$3.55	$4.68	$6.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $42.66	Professional	TC	$25.12	$33.11	$42.66
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $125.89 / $194.98	Facility		$79.43	$125.89	$194.98
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.30 / $57.54	Professional		$19.05	$26.30	$57.54
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.51 / $3.55 / $8.32	Professional	26	$2.51	$3.55	$8.32
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.91 / $45.71	Professional	TC	$16.22	$22.91	$45.71
United Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $47.86 / $154.88	Facility		$11.22	$47.86	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $25.12 / $51.29	Professional		$14.79	$25.12	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $1.95 / $3.55 / $10.23	Professional	26	$1.95	$3.55	$10.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $20.89 / $40.74	Professional	TC	$12.59	$20.89	$40.74