Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.04 / $22.04 / $131.88	Facility	26	$22.04	$22.04	$131.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $70.01 / $109.30	Professional		$57.31	$70.01	$109.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $28.10 / $43.12	Professional	26	$22.04	$28.10	$43.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.81 / $33.28 / $52.75	Professional	52	$27.81	$33.28	$52.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.56 / $41.70 / $68.37	Professional	TC	$31.56	$41.70	$68.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $101.62 / $180.40	Professional		$56.27	$101.62	$180.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $38.96 / $65.09	Professional	26	$21.30	$38.96	$65.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.52 / $62.07 / $100.62	Professional	TC	$31.52	$62.07	$100.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $77.29 / $94.20 / $160.76	Professional		$77.29	$94.20	$160.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.81 / $40.24 / $180.05	Professional	26	$32.81	$40.24	$180.05
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.48 / $53.96 / $180.05	Professional	TC	$44.48	$53.96	$180.05
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $64.97 / $110.08	Professional		$31.70	$64.97	$110.08
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.80 / $30.35 / $83.98	Professional	26	$25.80	$30.35	$83.98
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.17 / $54.65 / $104.69	Professional	TC	$30.17	$54.65	$104.69
United Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $80.68 / $129.00	Professional		$52.38	$80.68	$129.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $33.35 / $57.56	Professional	26	$22.13	$33.35	$57.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.90 / $43.17 / $74.78	Professional	TC	$28.90	$43.17	$74.78