Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.66 / $66.20 / $125.05	Professional		$45.66	$66.20	$125.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $23.65 / $52.81	Professional	26	$15.86	$23.65	$52.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $43.02 / $54.87	Professional	TC	$31.57	$43.02	$54.87
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $50.72 / $236.25	Professional		$23.82	$50.72	$236.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $59.90 / $125.38	Professional		$36.35	$59.90	$125.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.40 / $23.40 / $48.65	Professional	26	$12.40	$23.40	$48.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.22 / $37.15 / $87.99	Professional	TC	$23.22	$37.15	$87.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.07 / $74.38 / $105.41	Professional		$52.07	$74.38	$105.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.72 / $24.40 / $31.37	Professional	26	$15.72	$24.40	$31.37
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.35 / $57.59 / $74.05	Professional	TC	$36.35	$57.59	$74.05
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.50 / $57.49 / $101.17	Professional		$41.50	$57.49	$101.17
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.19 / $20.80 / $74.70	Professional	26	$15.19	$20.80	$74.70
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.06 / $39.26 / $70.73	Professional	TC	$28.06	$39.26	$70.73
United Facility/Professional Professional Modifier Low / Median / High Price $31.14 / $51.08 / $88.42	Professional		$31.14	$51.08	$88.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $18.97 / $31.91	Professional	26	$10.42	$18.97	$31.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.07 / $33.14 / $58.94	Professional	TC	$21.07	$33.14	$58.94