Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.64 / $113.26 / $168.87	Facility	26	$82.64	$113.26	$168.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.81 / $358.87 / $661.99	Professional		$240.81	$358.87	$661.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.64 / $110.37 / $176.65	Professional	26	$82.64	$110.37	$176.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.16 / $250.66 / $458.46	Professional	TC	$158.16	$250.66	$458.46
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $320.75 / $320.75 / $320.75	Professional		$320.75	$320.75	$320.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.74 / $525.44 / $1,036.14	Professional		$326.74	$525.44	$1,036.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.86 / $160.66 / $329.22	Professional	26	$95.86	$160.66	$329.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.53 / $354.13 / $706.93	Professional	TC	$234.53	$354.13	$706.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $389.75 / $546.49 / $630.77	Professional		$389.75	$546.49	$630.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.70 / $156.34 / $186.08	Professional	26	$113.70	$156.34	$186.08
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $276.05 / $390.15 / $444.69	Professional	TC	$276.05	$390.15	$444.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.81 / $352.98 / $605.65	Professional		$281.81	$352.98	$605.65
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.72 / $97.18 / $314.80	Professional	26	$80.72	$97.18	$314.80
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $211.36 / $254.65 / $440.31	Professional	TC	$211.36	$254.65	$440.31
United Facility/Professional Professional Modifier Low / Median / High Price $242.85 / $359.51 / $836.88	Professional		$242.85	$359.51	$836.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.95 / $107.82 / $235.16	Professional	26	$74.95	$107.82	$235.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.18 / $277.94 / $745.82	Professional	TC	$169.18	$277.94	$745.82