Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.58 / $15.58 / $140.66	Facility	26	$15.58	$15.58	$140.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.46 / $93.98 / $127.83	Professional		$59.46	$93.98	$127.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $23.98 / $39.68	Professional	26	$15.58	$23.98	$39.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.88 / $69.08 / $97.52	Professional	TC	$43.88	$69.08	$97.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $107.49 / $232.90	Professional		$54.95	$107.49	$232.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.70 / $27.66 / $54.49	Professional	26	$14.70	$27.66	$54.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $76.89 / $149.19	Professional	TC	$39.79	$76.89	$149.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $96.04 / $151.19 / $227.64	Professional		$96.04	$151.19	$227.64
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.63 / $36.97 / $59.22	Professional	26	$23.63	$36.97	$59.22
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.41 / $118.03 / $168.42	Professional	TC	$72.41	$118.03	$168.42
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.95 / $114.26 / $175.82	Professional		$92.95	$114.26	$175.82
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $27.44 / $121.12	Professional	26	$23.32	$27.44	$121.12
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.80 / $86.82 / $178.06	Professional	TC	$73.80	$86.82	$178.06
United Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $119.33 / $204.04	Professional		$54.52	$119.33	$204.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.11 / $30.68 / $44.25	Professional	26	$14.11	$30.68	$44.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $85.19 / $139.53	Professional	TC	$39.92	$85.19	$139.53