Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $416.87 / $758.58	Facility	26	$181.97	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $1,621.81	Professional		$338.84	$478.63	$1,621.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $331.13	Professional	26	$85.11	$125.89	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $630.96 / $630.96 / $630.96	Professional	50	$630.96	$630.96	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $676.08	Professional	TC	$257.04	$338.84	$676.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $562.34 / $933.25	Professional		$288.40	$562.34	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $109.65 / $190.55	Professional	26	$61.66	$109.65	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $436.52 / $758.58	Professional	TC	$223.87	$436.52	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $478.63 / $1,202.26	Professional		$407.38	$478.63	$1,202.26
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $1,202.26	Professional	26	$97.72	$112.20	$1,202.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $371.54 / $1,202.26	Professional	TC	$309.03	$371.54	$1,202.26
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $398.11 / $741.31	Professional		$338.84	$398.11	$741.31
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $144.54	Professional	26	$74.13	$87.10	$144.54
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $309.03 / $602.56	Professional	TC	$263.03	$309.03	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $467.74 / $812.83	Professional		$263.03	$467.74	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $165.96	Professional	26	$61.66	$91.20	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $363.08 / $660.69	Professional	TC	$194.98	$363.08	$660.69