Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.87 / $18.87 / $32.27	Facility	26	$18.87	$18.87	$32.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $62.21 / $100.87	Professional		$50.29	$62.21	$100.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.24 / $18.32 / $26.24	Professional	26	$15.24	$18.32	$26.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.30 / $30.63 / $41.77	Professional	52	$23.30	$30.63	$41.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $43.50 / $66.83	Professional	TC	$35.60	$43.50	$66.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.59 / $66.59 / $66.59	Professional		$66.59	$66.59	$66.59
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $144.00 / $320.00	Professional		$135.00	$144.00	$320.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $88.47 / $159.33	Professional		$51.33	$88.47	$159.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $25.72 / $47.13	Professional	26	$13.53	$25.72	$47.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.79 / $60.90 / $117.98	Professional	TC	$37.79	$60.90	$117.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $91.23 / $117.95	Professional		$69.86	$91.23	$117.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.35 / $26.30 / $34.01	Professional	26	$20.35	$26.30	$34.01
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.51 / $64.92 / $83.94	Professional	TC	$49.51	$64.92	$83.94
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.07 / $60.68 / $92.33	Professional		$50.07	$60.68	$92.33
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $17.30 / $51.58	Professional	26	$14.32	$17.30	$51.58
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.74 / $44.20 / $73.91	Professional	TC	$35.74	$44.20	$73.91
United Facility/Professional Professional Modifier Low / Median / High Price $46.59 / $69.59 / $123.37	Professional		$46.59	$69.59	$123.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $20.30 / $36.15	Professional	26	$13.19	$20.30	$36.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.33 / $50.66 / $92.53	Professional	TC	$32.33	$50.66	$92.53