Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $53.21 / $75.27	Professional		$33.86	$53.21	$75.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $8.48 / $11.67	Professional	26	$6.49	$8.48	$11.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $44.68 / $63.73	Professional	TC	$27.38	$44.68	$63.73
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $62.84 / $62.84 / $62.84	Professional		$62.84	$62.84	$62.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $55.64 / $118.75	Professional		$34.97	$55.64	$118.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $9.15 / $21.01	Professional	26	$5.80	$9.15	$21.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.54 / $47.23 / $107.89	Professional	TC	$29.54	$47.23	$107.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.90 / $66.14 / $83.72	Professional		$63.90	$66.14	$83.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $10.06 / $12.70	Professional	26	$9.88	$10.06	$12.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.97 / $56.08 / $71.09	Professional	TC	$53.97	$56.08	$71.09
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $51.55 / $67.27	Professional		$38.11	$51.55	$67.27
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $8.66 / $13.00	Professional	26	$7.36	$8.66	$13.00
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $44.83 / $62.26	Professional	TC	$40.74	$44.83	$62.26
United Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $37.52 / $96.70	Professional		$25.20	$37.52	$96.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.74 / $6.32 / $14.60	Professional	26	$4.74	$6.32	$14.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $32.46 / $76.47	Professional	TC	$21.22	$32.46	$76.47