Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.96 / $12.96 / $14.41	Facility	26	$12.96	$12.96	$14.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.86 / $56.13 / $95.83	Professional		$46.86	$56.13	$95.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.28 / $19.30	Professional	26	$10.47	$12.28	$19.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.43 / $27.47 / $31.78	Professional	52	$23.43	$27.47	$31.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.39 / $43.85 / $66.92	Professional	TC	$36.39	$43.85	$66.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.93 / $57.70 / $66.56	Professional		$49.93	$57.70	$66.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $12.31 / $19.70	Professional	26	$10.11	$12.31	$19.70
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $12.67 / $62.31 / $131.87	Professional		$12.67	$62.31	$131.87
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $11.97 / $15.54 / $31.35	Professional	26	$11.97	$15.54	$31.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.44 / $75.08 / $125.12	Professional		$57.44	$75.08	$125.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $16.45 / $26.88	Professional	26	$12.26	$16.45	$26.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.87 / $59.19 / $99.26	Professional	TC	$44.87	$59.19	$99.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.99 / $79.95 / $113.38	Professional		$58.99	$79.95	$113.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $15.47 / $21.94	Professional	26	$11.41	$15.47	$21.94
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.86 / $64.48 / $91.45	Professional	TC	$52.86	$64.48	$91.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $56.49 / $92.95	Professional		$42.76	$56.49	$92.95
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.58 / $11.54 / $48.17	Professional	26	$9.58	$11.54	$48.17
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.09 / $41.28 / $74.59	Professional	TC	$35.09	$41.28	$74.59
United Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $59.61 / $113.49	Professional		$42.28	$59.61	$113.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $12.73 / $23.49	Professional	26	$8.80	$12.73	$23.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.01 / $45.85 / $87.68	Professional	TC	$33.01	$45.85	$87.68