Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $51.11 / $71.23	Professional		$35.95	$51.11	$71.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $19.51 / $27.68	Professional	26	$16.50	$19.51	$27.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $27.76 / $48.17	Professional	TC	$19.39	$27.76	$48.17
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $52.02 / $71.64	Professional		$43.82	$52.02	$71.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.12 / $62.49 / $109.91	Professional		$28.12	$62.49	$109.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $23.36 / $43.01	Professional	26	$12.00	$23.36	$43.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.12 / $35.74 / $62.48	Professional	TC	$16.12	$35.74	$62.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $55.71 / $70.68	Professional		$54.35	$55.71	$70.68
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.95 / $23.27 / $29.70	Professional	26	$22.95	$23.27	$29.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.15 / $32.43 / $40.96	Professional	TC	$31.15	$32.43	$40.96
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $45.17 / $53.53	Professional		$30.56	$45.17	$53.53
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $20.20 / $39.94	Professional	26	$16.89	$20.20	$39.94
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $25.30 / $26.57	Professional	TC	$21.51	$25.30	$26.57
United Facility/Professional Professional Modifier Low / Median / High Price $27.42 / $36.64 / $76.13	Professional		$27.42	$36.64	$76.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $14.88 / $29.23	Professional	26	$11.26	$14.88	$29.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.26 / $22.40 / $40.99	Professional	TC	$15.26	$22.40	$40.99