Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.18 / $19.18 / $19.18	Facility	26	$19.18	$19.18	$19.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $74.14 / $96.80	Professional		$64.86	$74.14	$96.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $19.18 / $25.00	Professional	26	$17.78	$19.18	$25.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.87 / $54.52 / $71.80	Professional	TC	$47.87	$54.52	$71.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.28 / $34.36 / $35.28	Professional	26	$21.28	$34.36	$35.28
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $33.88 / $53.57	Professional	26	$17.82	$33.88	$53.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.67 / $110.77 / $110.77	Professional		$88.67	$110.77	$110.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.68 / $28.89 / $28.89	Professional	26	$23.68	$28.89	$28.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.98 / $81.89 / $81.89	Professional	TC	$64.98	$81.89	$81.89
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.75 / $62.88 / $92.55	Professional		$50.75	$62.88	$92.55
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $19.30 / $19.82	Professional	26	$16.41	$19.30	$19.82
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.84 / $57.46 / $77.28	Professional	TC	$48.84	$57.46	$77.28
United Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $95.64 / $172.86	Professional		$61.54	$95.64	$172.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.00 / $23.15 / $39.03	Professional	26	$15.00	$23.15	$39.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.49 / $73.88 / $137.94	Professional	TC	$45.49	$73.88	$137.94