Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.08 / $103.56 / $578.76	Professional		$52.08	$103.56	$578.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $24.69 / $43.84	Professional	26	$17.07	$24.69	$43.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.81 / $45.47 / $119.84	Professional	TC	$27.81	$45.47	$119.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $73.77 / $150.60	Professional		$41.25	$73.77	$150.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $27.66 / $48.50	Professional	26	$15.39	$27.66	$48.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $47.94 / $116.68	Professional	TC	$25.70	$47.94	$116.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $82.17 / $117.38 / $166.36	Professional		$82.17	$117.38	$166.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $28.96 / $40.38	Professional	26	$20.27	$28.96	$40.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.89 / $88.42 / $125.98	Professional	TC	$61.89	$88.42	$125.98
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.87 / $77.64 / $129.46	Professional		$56.87	$77.64	$129.46
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $23.03 / $38.72	Professional	26	$19.57	$23.03	$38.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.18 / $60.06 / $107.64	Professional	TC	$45.18	$60.06	$107.64
United Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $76.48 / $125.80	Professional		$40.13	$76.48	$125.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.38 / $24.26 / $37.01	Professional	26	$13.38	$24.26	$37.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.86 / $50.65 / $93.38	Professional	TC	$24.86	$50.65	$93.38