Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.98 / $5.50 / $30.90	Facility	26	$3.98	$5.50	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $43.65 / $169.82	Professional		$22.91	$43.65	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.88 / $4.57 / $15.14	Professional	26	$2.88	$4.57	$15.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.48 / $11.48 / $11.48	Professional	52	$11.48	$11.48	$11.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $114.82	Professional	TC	$19.05	$29.51	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $20.42 / $33.11	Professional		$17.78	$20.42	$33.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.40 / $3.24 / $4.90	Professional	26	$2.40	$3.24	$4.90
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $15.49 / $39.81	Professional		$3.24	$15.49	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $43.65 / $125.89	Professional		$25.12	$43.65	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $4.47 / $7.59	Professional	26	$3.09	$4.47	$7.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $40.74 / $123.03	Professional	TC	$22.39	$40.74	$123.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $60.26 / $74.13	Professional		$28.18	$60.26	$74.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.72 / $4.07 / $6.61	Professional	26	$3.72	$4.07	$6.61
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $25.70 / $41.69	Professional	TC	$23.99	$25.70	$41.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $66.07	Professional		$21.38	$25.12	$66.07
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.51 / $2.95 / $8.13	Professional	26	$2.51	$2.95	$8.13
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $22.39 / $57.54	Professional	TC	$18.62	$22.39	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $123.03	Professional		$24.55	$42.66	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.75 / $3.72 / $7.08	Professional	26	$2.75	$3.72	$7.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $109.65	Professional	TC	$19.95	$27.54	$109.65