Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.58 / $141.58 / $604.45	Facility	26	$141.58	$141.58	$604.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $375.78 / $487.44	Professional		$317.47	$375.78	$487.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $126.17 / $141.58 / $184.82	Professional	26	$126.17	$141.58	$184.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $234.55 / $324.18	Professional	TC	$185.65	$234.55	$324.18
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $418.20 / $418.20 / $418.20	Professional		$418.20	$418.20	$418.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.07 / $481.26 / $875.67	Professional		$339.07	$481.26	$875.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.07 / $187.78 / $330.54	Professional	26	$124.07	$187.78	$330.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.02 / $288.05 / $541.44	Professional	TC	$201.02	$288.05	$541.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $542.82 / $645.79 / $645.79	Professional		$542.82	$645.79	$645.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $175.98 / $205.06 / $205.06	Professional	26	$175.98	$205.06	$205.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $366.84 / $440.73 / $440.73	Professional	TC	$366.84	$440.73	$440.73
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.73 / $360.04 / $540.49	Professional		$293.73	$360.04	$540.49
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.02 / $128.02 / $250.96	Professional	26	$106.02	$128.02	$250.96
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $187.70 / $232.04 / $396.01	Professional	TC	$187.70	$232.04	$396.01
United Facility/Professional Professional Modifier Low / Median / High Price $296.11 / $460.74 / $812.69	Professional		$296.11	$460.74	$812.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.21 / $179.22 / $323.35	Professional	26	$116.21	$179.22	$323.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.25 / $294.42 / $523.73	Professional	TC	$186.25	$294.42	$523.73