Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $112.50 / $210.00	Professional		$61.16	$112.50	$210.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $32.67 / $59.50	Professional	26	$22.94	$32.67	$59.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.81 / $62.92 / $137.84	Professional	TC	$36.81	$62.92	$137.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.66 / $87.90 / $204.28	Professional		$54.66	$87.90	$204.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $40.60 / $73.86	Professional	26	$20.05	$40.60	$73.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.47 / $62.13 / $148.50	Professional	TC	$31.47	$62.13	$148.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $107.54 / $153.63 / $217.85	Professional		$107.54	$153.63	$217.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.07 / $35.82 / $49.91	Professional	26	$25.07	$35.82	$49.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.47 / $117.81 / $167.94	Professional	TC	$82.47	$117.81	$167.94
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.02 / $104.19 / $183.80	Professional		$72.02	$104.19	$183.80
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.23 / $32.21 / $93.54	Professional	26	$24.23	$32.21	$93.54
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.34 / $85.54 / $162.21	Professional	TC	$64.34	$85.54	$162.21
United Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $102.78 / $179.87	Professional		$51.93	$102.78	$179.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.59 / $32.50 / $50.89	Professional	26	$16.59	$32.50	$50.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.70 / $61.36 / $124.63	Professional	TC	$32.70	$61.36	$124.63