Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.62 / $274.32 / $645.48	Professional		$189.62	$274.32	$645.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $56.36 / $147.05	Professional	26	$38.84	$56.36	$147.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.55 / $220.17 / $400.64	Professional	TC	$109.55	$220.17	$400.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $225.90 / $225.90 / $225.90	Professional		$225.90	$225.90	$225.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.78 / $247.61 / $577.78	Professional		$122.78	$247.61	$577.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $65.59 / $124.45	Professional	26	$34.99	$65.59	$124.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.68 / $204.77 / $479.84	Professional	TC	$87.68	$204.77	$479.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $289.49 / $413.56 / $586.85	Professional		$289.49	$413.56	$586.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $64.23 / $89.25	Professional	26	$44.97	$64.23	$89.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.52 / $349.32 / $497.58	Professional	TC	$244.52	$349.32	$497.58
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.00 / $334.04 / $549.74	Professional		$215.00	$334.04	$549.74
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.32 / $53.74 / $176.90	Professional	26	$43.32	$53.74	$176.90
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $220.29 / $286.68 / $446.40	Professional	TC	$220.29	$286.68	$446.40
United Facility/Professional Professional Modifier Low / Median / High Price $119.45 / $267.41 / $522.98	Professional		$119.45	$267.41	$522.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.62 / $54.52 / $91.01	Professional	26	$29.62	$54.52	$91.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.49 / $273.27 / $511.93	Professional	TC	$157.49	$273.27	$511.93