Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.07 / $96.08 / $410.02	Facility	26	$96.07	$96.08	$410.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.87 / $330.97 / $440.19	Professional		$280.87	$330.97	$440.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.36 / $96.08 / $124.52	Professional	26	$85.36	$96.08	$124.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $195.64 / $231.33 / $320.47	Professional	TC	$195.64	$231.33	$320.47
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $352.80 / $352.80 / $352.80	Professional		$352.80	$352.80	$352.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.36 / $422.52 / $750.37	Professional		$291.36	$422.52	$750.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.19 / $126.36 / $221.89	Professional	26	$84.19	$126.36	$221.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.94 / $294.39 / $528.48	Professional	TC	$205.94	$294.39	$528.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $409.34 / $487.90 / $487.90	Professional		$409.34	$487.90	$487.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $118.24 / $137.99 / $137.99	Professional	26	$118.24	$137.99	$137.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $291.10 / $349.91 / $349.91	Professional	TC	$291.10	$349.91	$349.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.37 / $345.47 / $490.35	Professional		$281.37	$345.47	$490.35
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.12 / $100.36 / $286.66	Professional	26	$83.12	$100.36	$286.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $198.25 / $245.10 / $397.21	Professional	TC	$198.25	$245.10	$397.21
United Facility/Professional Professional Modifier Low / Median / High Price $271.64 / $377.53 / $672.23	Professional		$271.64	$377.53	$672.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.27 / $119.14 / $202.92	Professional	26	$77.27	$119.14	$202.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.02 / $269.79 / $476.94	Professional	TC	$185.02	$269.79	$476.94