Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.53 / $24.53 / $28.02	Facility	26	$24.53	$24.53	$28.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.99 / $34.69 / $52.87	Professional		$29.99	$34.69	$52.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.54 / $22.72 / $33.63	Professional	26	$19.54	$22.72	$33.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.00 / $17.18 / $20.01	Professional	52	$15.00	$17.18	$20.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $11.97 / $17.21	Professional	TC	$10.11	$11.97	$17.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $33.20 / $37.22	Professional		$29.13	$33.20	$37.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.77 / $18.85 / $22.80	Professional	26	$18.77	$18.85	$22.80
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $34.33 / $45.42 / $108.75	Professional		$34.33	$45.42	$108.75
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $22.24 / $27.90 / $52.62	Professional	26	$22.24	$27.90	$52.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $45.53 / $76.43	Professional		$35.04	$45.53	$76.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.62 / $29.65 / $49.94	Professional	26	$22.62	$29.65	$49.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.22 / $15.70 / $26.98	Professional	TC	$12.22	$15.70	$26.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $47.06 / $66.73	Professional		$34.71	$47.06	$66.73
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $28.78 / $40.81	Professional	26	$21.23	$28.78	$40.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.98 / $18.28 / $25.92	Professional	TC	$14.98	$18.28	$25.92
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.51 / $30.59 / $53.01	Professional		$12.51	$30.59	$53.01
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $23.38 / $37.02	Professional	26	$17.39	$23.38	$37.02
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.02 / $10.68 / $21.87	Professional	TC	$9.02	$10.68	$21.87
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $34.29 / $63.63	Professional		$25.12	$34.29	$63.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.12 / $23.46 / $44.15	Professional	26	$16.12	$23.46	$44.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.66 / $12.21 / $22.99	Professional	TC	$8.66	$12.21	$22.99