Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $204.17 / $323.59	Facility	26	$114.82	$204.17	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $398.11	Professional		$173.78	$218.78	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $181.97 / $407.38	Professional	TC	$134.90	$181.97	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $489.78	Professional		$177.83	$275.42	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $223.87 / $426.58	Professional	TC	$147.91	$223.87	$426.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	TC	$234.42	$234.42	$234.42
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $436.52	Professional		$199.53	$234.42	$436.52
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $190.55 / $354.81	Professional	TC	$162.18	$190.55	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $467.74	Professional		$169.82	$269.15	$467.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $218.78 / $389.05	Professional	TC	$138.04	$218.78	$389.05