Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.79 / $47.79 / $47.79	Facility	26	$47.79	$47.79	$47.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.68 / $85.96 / $119.71	Professional		$68.68	$85.96	$119.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.85 / $44.16 / $62.35	Professional	26	$36.85	$44.16	$62.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.35 / $41.17 / $57.36	Professional	TC	$33.35	$41.17	$57.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.86 / $94.86 / $94.86	Professional		$94.86	$94.86	$94.86
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Professional		$100.27	$100.27	$100.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.59 / $47.59 / $47.59	Facility	26	$47.59	$47.59	$47.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.44 / $113.69 / $213.24	Professional		$67.44	$113.69	$213.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.57 / $61.01 / $111.96	Professional	26	$32.57	$61.01	$111.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.71 / $55.66 / $108.61	Professional	TC	$27.71	$55.66	$108.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.15 / $129.96 / $175.00	Professional		$100.15	$129.96	$175.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.90 / $63.02 / $81.69	Professional	26	$48.90	$63.02	$81.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.25 / $66.94 / $87.02	Professional	TC	$51.25	$66.94	$87.02
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $67.52 / $108.24	Professional		$35.58	$67.52	$108.24
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.71 / $49.76 / $79.43	Professional	26	$34.71	$49.76	$79.43
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.81 / $40.56 / $63.26	Professional	TC	$32.81	$40.56	$63.26
United Facility/Professional Professional Modifier Low / Median / High Price $59.51 / $95.42 / $177.92	Professional		$59.51	$95.42	$177.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $49.20 / $88.18	Professional	26	$33.04	$49.20	$88.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.01 / $46.51 / $89.74	Professional	TC	$31.01	$46.51	$89.74