Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.72 / $741.31	Facility	26	$8.71	$10.72	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $186.21	Professional		$50.12	$69.18	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $34.67	Professional	26	$7.94	$10.47	$34.67
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $53.70 / $104.71	Professional	TC	$41.69	$53.70	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $54.95 / $74.13	Professional		$45.71	$54.95	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.55 / $12.88	Professional	26	$7.41	$9.55	$12.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	TC	$46.77	$46.77	$46.77
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $67.61 / $169.82	Professional		$14.79	$67.61	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Facility	26	$14.13	$14.13	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $77.62 / $134.90	Professional		$58.88	$77.62	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.75 / $19.50	Professional	26	$8.91	$11.75	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $66.07 / $114.82	Professional	TC	$48.98	$66.07	$114.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $128.82	Professional		$67.61	$89.13	$128.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.88 / $18.20	Professional	26	$9.55	$12.88	$18.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $77.62 / $112.20	Professional	TC	$64.57	$77.62	$112.20
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $120.23	Professional		$47.86	$66.07	$120.23
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.55 / $21.88	Professional	26	$7.08	$9.55	$21.88
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $54.95 / $109.65	Professional	TC	$39.81	$54.95	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $109.65	Professional		$43.65	$61.66	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.55 / $16.60	Professional	26	$6.46	$9.55	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $52.48 / $93.33	Professional	TC	$37.15	$52.48	$93.33