Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $295.12 / $457.09	Facility	26	$162.18	$295.12	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $588.84	Professional		$199.53	$275.42	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $134.90	Professional	26	$47.86	$63.10	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $537.03	Professional	TC	$144.54	$218.78	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $407.38 / $776.25	Professional		$199.53	$407.38	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $128.82	Professional	26	$43.65	$75.86	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $338.84 / $676.08	Professional	TC	$144.54	$338.84	$676.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $302.00 / $316.23	Professional		$263.03	$302.00	$316.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $81.28	Professional	26	$70.79	$79.43	$81.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $218.78 / $234.42	Professional	TC	$194.98	$218.78	$234.42
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $426.58	Professional		$204.17	$239.88	$426.58
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $104.71	Professional	26	$52.48	$61.66	$104.71
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $177.83 / $316.23	Professional	TC	$151.36	$177.83	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $331.13 / $676.08	Professional		$181.97	$331.13	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $69.18 / $120.23	Professional	26	$45.71	$69.18	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $239.88 / $588.84	Professional	TC	$131.83	$239.88	$588.84