Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.54 / $87.11 / $171.02	Professional		$59.54	$87.11	$171.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $58.37 / $430.58	Professional	26	$43.42	$58.37	$430.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $32.49 / $47.90	Professional	TC	$20.17	$32.49	$47.90
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $144.00 / $336.75	Professional		$65.75	$144.00	$336.75
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $119.86 / $119.86 / $119.86	Professional	26	$119.86	$119.86	$119.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.65 / $89.09 / $162.28	Professional		$50.65	$89.09	$162.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.72 / $62.83 / $104.94	Professional	26	$32.72	$62.83	$104.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $29.73 / $57.33	Professional	TC	$16.44	$29.73	$57.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.12 / $116.01 / $170.00	Professional		$74.12	$116.01	$170.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.53 / $62.19 / $86.83	Professional	26	$43.53	$62.19	$86.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.59 / $48.48 / $79.62	Professional	TC	$30.59	$48.48	$79.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.60 / $67.18 / $123.25	Professional		$40.60	$67.18	$123.25
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.31 / $52.63 / $112.90	Professional	26	$41.31	$52.63	$112.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.74 / $33.86 / $64.84	Professional	TC	$24.74	$33.86	$64.84
United Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $80.26 / $132.24	Professional		$44.31	$80.26	$132.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.42 / $56.12 / $89.17	Professional	26	$28.42	$56.12	$89.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.27 / $26.31 / $49.37	Professional	TC	$17.27	$26.31	$49.37