Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.36 / $101.95 / $137.69	Professional		$82.36	$101.95	$137.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.41 / $73.01 / $134.87	Professional	26	$53.41	$73.01	$134.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $36.58 / $61.21	Professional	TC	$20.38	$36.58	$61.21
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $381.65 / $381.65 / $381.65	Professional		$381.65	$381.65	$381.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $110.32 / $239.84	Professional		$66.45	$110.32	$239.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.14 / $85.54 / $153.57	Professional	26	$45.14	$85.54	$153.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.09 / $35.54 / $85.63	Professional	TC	$16.09	$35.54	$85.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $84.77 / $121.10 / $169.76	Professional		$84.77	$121.10	$169.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.20 / $88.85 / $123.73	Professional	26	$62.20	$88.85	$123.73
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $32.25 / $46.04	Professional	TC	$22.58	$32.25	$46.04
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.08 / $91.12 / $194.70	Professional		$50.08	$91.12	$194.70
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.17 / $72.61 / $147.72	Professional	26	$57.17	$72.61	$147.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $25.82 / $88.67	Professional	TC	$18.85	$25.82	$88.67
United Facility/Professional Professional Modifier Low / Median / High Price $55.29 / $94.12 / $162.71	Professional		$55.29	$94.12	$162.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $74.87 / $110.79	Professional	26	$40.56	$74.87	$110.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.94 / $26.93 / $47.72	Professional	TC	$14.94	$26.93	$47.72