Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $218.41 / $310.48	Professional		$148.80	$218.41	$310.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.53 / $41.16 / $131.35	Professional	26	$27.53	$41.16	$131.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.73 / $188.77 / $696.04	Professional	TC	$117.73	$188.77	$696.04
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $552.00 / $552.00 / $552.00	Professional		$552.00	$552.00	$552.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $226.73 / $504.88	Professional		$118.48	$226.73	$504.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.17 / $45.27 / $86.01	Professional	26	$24.17	$45.27	$86.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.23 / $184.88 / $437.41	Professional	TC	$94.23	$184.88	$437.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $203.45 / $290.64 / $412.53	Professional		$203.45	$290.64	$412.53
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.08 / $41.54 / $57.73	Professional	26	$29.08	$41.54	$57.73
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $174.37 / $249.10 / $354.81	Professional	TC	$174.37	$249.10	$354.81
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.87 / $286.57 / $474.92	Professional		$227.87	$286.57	$474.92
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.76 / $36.86 / $122.21	Professional	26	$29.76	$36.86	$122.21
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $203.42 / $251.57 / $458.21	Professional	TC	$203.42	$251.57	$458.21
United Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $275.27 / $409.39	Professional		$115.20	$275.27	$409.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.91 / $35.15 / $62.53	Professional	26	$18.91	$35.15	$62.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.56 / $227.48 / $359.37	Professional	TC	$98.56	$227.48	$359.37