Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $71.78 / $110.69	Professional		$53.12	$71.78	$110.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $22.79 / $31.41	Professional	26	$17.23	$22.79	$31.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.89 / $50.37 / $79.28	Professional	TC	$35.89	$50.37	$79.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $80.94 / $172.00	Professional		$42.15	$80.94	$172.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.43 / $25.87 / $53.90	Professional	26	$13.43	$25.87	$53.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.72 / $54.69 / $126.00	Professional	TC	$28.72	$54.69	$126.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $138.99 / $196.94	Professional		$97.29	$138.99	$196.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.88 / $34.11 / $47.53	Professional	26	$23.88	$34.11	$47.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.41 / $104.87 / $149.40	Professional	TC	$73.41	$104.87	$149.40
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $94.42 / $147.02	Professional		$72.73	$94.42	$147.02
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.79 / $26.38 / $67.68	Professional	26	$21.79	$26.38	$67.68
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.62 / $68.78 / $125.28	Professional	TC	$55.62	$68.78	$125.28
United Facility/Professional Professional Modifier Low / Median / High Price $40.96 / $85.38 / $148.99	Professional		$40.96	$85.38	$148.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $25.74 / $40.43	Professional	26	$12.46	$25.74	$40.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.49 / $65.59 / $113.25	Professional	TC	$41.49	$65.59	$113.25