Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.36 / $33.36 / $169.21	Facility	26	$33.36	$33.36	$169.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.25 / $111.90 / $155.76	Professional		$71.25	$111.90	$155.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.92 / $72.00 / $115.80	Professional	TC	$42.92	$72.00	$115.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $151.08 / $283.64	Professional		$81.78	$151.08	$283.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $95.92 / $207.99	Professional	TC	$52.48	$95.92	$207.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $126.02 / $149.63 / $247.52	Professional		$126.02	$149.63	$247.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.73 / $97.09 / $131.66	Professional	TC	$80.73	$97.09	$131.66
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.21 / $100.07 / $168.82	Professional		$82.21	$100.07	$168.82
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.52 / $63.44 / $154.40	Professional	TC	$52.52	$63.44	$154.40
United Facility/Professional Professional Modifier Low / Median / High Price $83.79 / $138.38 / $227.25	Professional		$83.79	$138.38	$227.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.13 / $78.30 / $143.79	Professional	TC	$50.13	$78.30	$143.79