Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.02 / $10.02 / $50.16	Facility	26	$10.02	$10.02	$50.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.28 / $94.81 / $175.74	Professional		$73.28	$94.81	$175.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.98 / $24.32	Professional	26	$10.02	$11.98	$24.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.25 / $83.36 / $143.44	Professional	TC	$63.25	$83.36	$143.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.62 / $156.54 / $289.45	Professional		$85.62	$156.54	$289.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $14.19 / $24.36	Professional	26	$8.36	$14.19	$24.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.08 / $140.76 / $253.83	Professional	TC	$77.08	$140.76	$253.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.65 / $156.82 / $376.48	Professional		$117.65	$156.82	$376.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.17 / $15.44 / $20.99	Professional	26	$13.17	$15.44	$20.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.35 / $125.53 / $170.10	Professional	TC	$104.35	$125.53	$170.10
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $90.07 / $143.84	Professional		$76.56	$90.07	$143.84
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $11.58 / $20.43	Professional	26	$9.84	$11.58	$20.43
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.72 / $78.48 / $132.80	Professional	TC	$66.72	$78.48	$132.80
United Facility/Professional Professional Modifier Low / Median / High Price $94.81 / $139.02 / $231.81	Professional		$94.81	$139.02	$231.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.65 / $12.65 / $22.12	Professional	26	$8.65	$12.65	$22.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.02 / $124.29 / $199.75	Professional	TC	$80.02	$124.29	$199.75