Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $33.11 / $371.54	Facility	26	$18.20	$33.11	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $346.74	Professional		$53.70	$75.86	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $95.50	Professional	26	$15.85	$21.88	$95.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $199.53 / $263.03	Professional	50	$28.84	$199.53	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $44.67 / $89.13	Professional	TC	$36.31	$44.67	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $60.26 / $109.65	Professional		$53.70	$60.26	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	26	$33.88	$33.88	$33.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $323.59	Professional		$134.90	$144.54	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $89.13 / $158.49	Professional		$51.29	$89.13	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $26.92 / $46.77	Professional	26	$14.13	$26.92	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $63.10 / $114.82	Professional	TC	$38.02	$63.10	$114.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $131.83	Professional		$100.00	$109.65	$131.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $30.20 / $36.31	Professional	26	$27.54	$30.20	$36.31
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $79.43 / $95.50	Professional	TC	$72.44	$79.43	$95.50
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $147.91	Professional		$52.48	$66.07	$147.91
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.62 / $44.67	Professional	26	$14.79	$18.62	$44.67
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $47.86 / $104.71	Professional	TC	$37.15	$47.86	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $123.03	Professional		$46.77	$66.07	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.95 / $35.48	Professional	26	$13.18	$19.95	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $47.86 / $87.10	Professional	TC	$33.11	$47.86	$87.10