Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.44 / $15.45 / $21.62	Facility	26	$13.44	$15.45	$21.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $59.38 / $91.31	Professional		$36.15	$59.38	$91.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $12.93 / $20.85	Professional	26	$9.49	$12.93	$20.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.42 / $43.68 / $69.28	Professional	TC	$26.42	$43.68	$69.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.60 / $39.58 / $45.68	Professional		$35.60	$39.58	$45.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.56 / $16.89	Professional	26	$8.66	$10.56	$16.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $61.23 / $172.00	Professional		$42.62	$61.23	$172.00
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $10.27 / $14.38 / $30.71	Professional	26	$10.27	$14.38	$30.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.76 / $75.90 / $133.02	Professional		$44.76	$75.90	$133.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $16.70 / $26.62	Professional	26	$11.08	$16.70	$26.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.89 / $58.20 / $102.64	Professional	TC	$33.89	$58.20	$102.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.91 / $54.79 / $157.19	Professional		$44.91	$54.79	$157.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $13.31 / $38.19	Professional	26	$10.67	$13.31	$38.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.00 / $41.48 / $119.00	Professional	TC	$34.00	$41.48	$119.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $68.04 / $105.41	Professional		$49.72	$68.04	$105.41
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $11.94 / $60.48	Professional	26	$10.15	$11.94	$60.48
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.27 / $49.42 / $78.81	Professional	TC	$39.27	$49.42	$78.81
United Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $60.33 / $116.62	Professional		$33.07	$60.33	$116.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $13.74 / $23.96	Professional	26	$8.02	$13.74	$23.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.04 / $47.31 / $91.46	Professional	TC	$25.04	$47.31	$91.46