Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $141.25 / $309.03	Facility	26	$60.26	$141.25	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $275.42	Professional		$75.86	$112.20	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $64.57 / $181.97	Professional	26	$20.89	$64.57	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $81.28 / $186.21	Professional	TC	$56.23	$81.28	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $199.53	Professional		$56.23	$104.71	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $28.18 / $52.48	Professional	26	$14.79	$28.18	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $77.62 / $147.91	Professional	TC	$41.69	$77.62	$147.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $229.09	Professional		$95.50	$154.88	$229.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $37.15 / $58.88	Professional	26	$23.44	$37.15	$58.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $117.49 / $169.82	Professional	TC	$72.44	$117.49	$169.82
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $223.87	Professional		$97.72	$114.82	$223.87
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $27.54 / $63.10	Professional	26	$23.44	$27.54	$63.10
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $87.10 / $177.83	Professional	TC	$74.13	$87.10	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $169.82	Professional		$56.23	$102.33	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $25.70 / $43.65	Professional	26	$14.13	$25.70	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $77.62 / $125.89	Professional	TC	$43.65	$77.62	$125.89