Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $234.42 / $416.87	Professional		$162.18	$234.42	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $213.80	Professional	26	$30.90	$41.69	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $204.17 / $691.83	Professional	TC	$128.82	$204.17	$691.83
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $223.87 / $467.74	Professional		$117.49	$223.87	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $44.67 / $85.11	Professional	26	$23.99	$44.67	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $186.21 / $416.87	Professional	TC	$93.33	$186.21	$416.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $416.87	Professional		$204.17	$323.59	$416.87
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $44.67 / $57.54	Professional	26	$29.51	$44.67	$57.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $275.42 / $354.81	Professional	TC	$173.78	$275.42	$354.81
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $316.23 / $575.44	Professional		$245.47	$316.23	$575.44
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $46.77 / $83.18	Professional	26	$29.51	$46.77	$83.18
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $263.03 / $501.19	Professional	TC	$213.80	$263.03	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $245.47 / $407.38	Professional		$114.82	$245.47	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $33.11 / $58.88	Professional	26	$19.05	$33.11	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $204.17 / $363.08	Professional	TC	$97.72	$204.17	$363.08