Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $162.18 / $245.47	Professional		$91.20	$162.18	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.89 / $47.86	Professional	26	$15.14	$20.89	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $138.04 / $257.04	Professional	TC	$77.62	$138.04	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $165.96 / $331.13	Professional		$72.44	$165.96	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $28.84 / $79.43	Professional	26	$13.80	$28.84	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $109.65 / $263.03	Professional	TC	$57.54	$109.65	$263.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $295.12	Professional		$144.54	$229.09	$295.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $25.12 / $32.36	Professional	26	$16.22	$25.12	$32.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $204.17 / $263.03	Professional	TC	$125.89	$204.17	$263.03
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $363.08	Professional		$128.82	$194.98	$363.08
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $27.54 / $97.72	Professional	26	$16.60	$27.54	$97.72
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $169.82 / $302.00	Professional	TC	$112.20	$169.82	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $257.04	Professional		$85.11	$141.25	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $23.44 / $47.86	Professional	26	$10.72	$23.44	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $123.03 / $213.80	Professional	TC	$75.86	$123.03	$213.80