Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.24 / $26.24 / $148.80	Facility	26	$26.24	$26.24	$148.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $75.53 / $129.27	Professional		$65.88	$75.53	$129.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.24 / $30.69 / $51.26	Professional	26	$26.24	$30.69	$51.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.51 / $47.00 / $80.95	Professional	TC	$37.51	$47.00	$80.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $125.12 / $204.28	Professional		$62.71	$125.12	$204.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $44.58 / $73.45	Professional	26	$23.23	$44.58	$73.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.92 / $73.45 / $121.91	Professional	TC	$38.92	$73.45	$121.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $84.40 / $102.94 / $175.55	Professional		$84.40	$102.94	$175.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $42.81 / $72.53	Professional	26	$34.86	$42.81	$72.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.53 / $60.13 / $103.02	Professional	TC	$49.53	$60.13	$103.02
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.40 / $101.83 / $163.16	Professional		$81.40	$101.83	$163.16
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.78 / $35.03 / $96.79	Professional	26	$29.78	$35.03	$96.79
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.79 / $67.88 / $110.77	Professional	TC	$56.79	$67.88	$110.77
United Facility/Professional Professional Modifier Low / Median / High Price $58.04 / $101.41 / $174.12	Professional		$58.04	$101.41	$174.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $36.81 / $66.44	Professional	26	$23.81	$36.81	$66.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.43 / $65.76 / $120.72	Professional	TC	$33.43	$65.76	$120.72