Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $210.28 / $210.29 / $210.29	Facility	26	$210.28	$210.29	$210.29
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $206.42 / $206.42 / $320.25	Facility	53	$206.42	$206.42	$320.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $690.34 / $927.12 / $1,444.58	Professional		$690.34	$927.12	$1,444.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.85 / $184.42 / $269.43	Professional	26	$106.85	$184.42	$269.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $335.54 / $430.47 / $566.40	Professional	52	$335.54	$430.47	$566.40
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $134.22 / $172.19 / $226.56	Professional	53	$134.22	$172.19	$226.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $564.08 / $742.11 / $1,120.40	Professional	TC	$564.08	$742.11	$1,120.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.77 / $186.77 / $186.77	Facility	26	$186.77	$186.77	$186.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $702.28 / $1,110.41 / $1,994.03	Professional		$702.28	$1,110.41	$1,994.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.35 / $201.87 / $352.69	Professional	26	$95.35	$201.87	$352.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $599.76 / $916.88 / $1,607.45	Professional	TC	$599.76	$916.88	$1,607.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $817.71 / $1,073.81 / $1,388.65	Professional		$817.71	$1,073.81	$1,388.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.43 / $160.30 / $207.06	Professional	26	$125.43	$160.30	$207.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $692.27 / $913.50 / $1,181.58	Professional	TC	$692.27	$913.50	$1,181.58
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $718.14 / $869.33 / $1,455.09	Professional		$718.14	$869.33	$1,455.09
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.60 / $119.00 / $261.36	Professional	26	$98.60	$119.00	$261.36
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $596.86 / $738.15 / $1,236.35	Professional	TC	$596.86	$738.15	$1,236.35
United Facility/Professional Professional Modifier Low / Median / High Price $633.62 / $897.85 / $1,702.05	Professional		$633.62	$897.85	$1,702.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.93 / $147.10 / $268.63	Professional	26	$88.93	$147.10	$268.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $502.43 / $816.95 / $1,460.74	Professional	TC	$502.43	$816.95	$1,460.74