Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.64 / $8.64 / $15.36	Facility	26	$8.64	$8.64	$15.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $58.43 / $98.59	Professional		$48.67	$58.43	$98.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.76 / $15.00	Professional	26	$7.45	$8.76	$15.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.34 / $28.78 / $33.70	Professional	52	$24.34	$28.78	$33.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $49.36 / $75.31	Professional	TC	$40.84	$49.36	$75.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.39 / $57.27 / $95.50	Professional		$51.39	$57.27	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $9.15 / $12.64	Professional	26	$7.54	$9.15	$12.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.29 / $81.20 / $169.14	Professional		$15.29	$81.20	$169.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.53 / $76.73 / $132.88	Professional		$59.53	$76.73	$132.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.05 / $11.62 / $19.60	Professional	26	$9.05	$11.62	$19.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.01 / $65.78 / $112.69	Professional	TC	$50.01	$65.78	$112.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $79.09 / $112.17	Professional		$58.36	$79.09	$112.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $11.58 / $16.42	Professional	26	$8.53	$11.58	$16.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.35 / $67.53 / $95.76	Professional	TC	$55.35	$67.53	$95.76
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $61.38 / $98.60	Professional		$47.06	$61.38	$98.60
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $8.97 / $61.11	Professional	26	$7.11	$8.97	$61.11
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.28 / $48.48 / $85.32	Professional	TC	$38.28	$48.48	$85.32
United Facility/Professional Professional Modifier Low / Median / High Price $42.39 / $57.38 / $111.75	Professional		$42.39	$57.38	$111.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.18 / $9.36 / $17.03	Professional	26	$6.18	$9.36	$17.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.07 / $49.58 / $94.96	Professional	TC	$36.07	$49.58	$94.96