Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.85 / $56.85 / $294.88	Facility	26	$56.85	$56.85	$294.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.34 / $461.65 / $546.70	Professional		$400.34	$461.65	$546.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.49 / $64.75 / $72.75	Professional	26	$54.49	$64.75	$72.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.94 / $394.38 / $477.91	Professional	TC	$335.94	$394.38	$477.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.68 / $602.55 / $1,019.67	Professional		$353.68	$602.55	$1,019.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.64 / $84.19 / $141.61	Professional	26	$48.64	$84.19	$141.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.39 / $512.52 / $883.42	Professional	TC	$303.39	$512.52	$883.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $597.13 / $597.13 / $597.13	Professional		$597.13	$597.13	$597.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.51 / $87.51 / $87.51	Professional	26	$87.51	$87.51	$87.51
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $509.61 / $509.61 / $509.61	Professional	TC	$509.61	$509.61	$509.61
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $420.48 / $494.68 / $680.36	Professional		$420.48	$494.68	$680.36
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.28 / $67.39 / $101.07	Professional	26	$57.28	$67.39	$101.07
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $363.20 / $427.29 / $629.96	Professional	TC	$363.20	$427.29	$629.96
United Facility/Professional Professional Modifier Low / Median / High Price $417.91 / $588.12 / $1,006.53	Professional		$417.91	$588.12	$1,006.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $83.25 / $139.47	Professional	26	$59.82	$83.25	$139.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $350.76 / $502.33 / $872.51	Professional	TC	$350.76	$502.33	$872.51