Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.71 / $34.53 / $259.30	Facility		$17.71	$34.53	$259.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $243.58	Facility	26	$17.71	$17.71	$243.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.82 / $18.44 / $49.91	Professional		$10.82	$18.44	$49.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $18.44 / $49.97	Professional	26	$12.91	$18.44	$49.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.45 / $66.45 / $66.45	Professional	26	$66.45	$66.45	$66.45
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $85.50 / $85.50 / $85.50	Professional		$85.50	$85.50	$85.50
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $25.88 / $27.17	Professional	26	$25.88	$25.88	$27.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7.13 / $7.13 / $30.43	Facility		$7.13	$7.13	$30.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $43.45	Professional		$43.45	$43.45	$43.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	26	$40.47	$40.47	$40.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $67.00 / $92.07	Professional		$35.36	$67.00	$92.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $62.65 / $85.45	Professional	26	$32.83	$62.65	$85.45
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $2.49 / $2.65 / $8,702.00	Facility		$2.49	$2.65	$8,702.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.99 / $14.11 / $14.46	Professional		$11.99	$14.11	$14.46
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.53 / $21.53 / $25.33	Professional	26	$21.53	$21.53	$25.33
United Facility/Professional Professional Modifier Low / Median / High Price $15.47 / $25.20 / $43.98	Professional		$15.47	$25.20	$43.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $23.35 / $43.35	Professional	26	$16.20	$23.35	$43.35