Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.11 / $49.12 / $239.00	Facility	26	$49.11	$49.12	$239.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.75 / $174.71 / $208.46	Professional		$119.75	$174.71	$208.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.63 / $54.47 / $64.29	Professional	26	$38.63	$54.47	$64.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.12 / $116.85 / $144.07	Professional	TC	$81.12	$116.85	$144.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $241.34 / $374.43	Professional		$139.66	$241.34	$374.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.57 / $69.65 / $117.70	Professional	26	$39.57	$69.65	$117.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.35 / $164.51 / $256.89	Professional	TC	$98.35	$164.51	$256.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $243.94 / $243.94 / $243.94	Professional		$243.94	$243.94	$243.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.09 / $73.09 / $73.09	Professional	26	$73.09	$73.09	$73.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.84 / $170.84 / $170.84	Professional	TC	$170.84	$170.84	$170.84
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.38 / $171.11 / $210.11	Professional		$123.38	$171.11	$210.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.91 / $55.19 / $72.23	Professional	26	$46.91	$55.19	$72.23
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.17 / $120.20 / $208.48	Professional	TC	$102.17	$120.20	$208.48
United Facility/Professional Professional Modifier Low / Median / High Price $155.22 / $214.03 / $369.59	Professional		$155.22	$214.03	$369.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.59 / $68.20 / $114.51	Professional	26	$46.59	$68.20	$114.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.39 / $146.44 / $255.34	Professional	TC	$108.39	$146.44	$255.34