Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.34 / $33.34 / $178.88	Facility	26	$33.34	$33.34	$178.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.44 / $145.35 / $210.86	Professional		$96.44	$145.35	$210.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.41 / $41.53 / $64.80	Professional	26	$27.41	$41.53	$64.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $99.16 / $160.26	Professional	TC	$63.10	$99.16	$160.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $161.50 / $161.50 / $295.50	Professional		$161.50	$161.50	$295.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $147.76 / $320.02	Professional		$80.45	$147.76	$320.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.16 / $45.37 / $101.91	Professional	26	$24.16	$45.37	$101.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.27 / $103.40 / $241.39	Professional	TC	$50.27	$103.40	$241.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $129.63 / $204.20 / $306.81	Professional		$129.63	$204.20	$306.81
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.90 / $46.75 / $74.95	Professional	26	$29.90	$46.75	$74.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.74 / $157.94 / $231.86	Professional	TC	$99.74	$157.94	$231.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.89 / $149.85 / $235.92	Professional		$121.89	$149.85	$235.92
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.61 / $34.83 / $156.44	Professional	26	$29.61	$34.83	$156.44
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.77 / $115.02 / $209.50	Professional	TC	$97.77	$115.02	$209.50
United Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $156.66 / $264.02	Professional		$80.90	$156.66	$264.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.77 / $40.93 / $64.16	Professional	26	$19.77	$40.93	$64.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.77 / $115.49 / $193.52	Professional	TC	$59.77	$115.49	$193.52