Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.45 / $103.87 / $141.74	Professional		$87.45	$103.87	$141.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $79.18 / $109.45	Professional	26	$65.61	$79.18	$109.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $28.24 / $36.77	Professional	TC	$17.73	$28.24	$36.77
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $101.55 / $101.55 / $101.55	Professional		$101.55	$101.55	$101.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $121.34 / $208.20	Professional		$85.59	$121.34	$208.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.00 / $87.47 / $156.46	Professional	26	$64.00	$87.47	$156.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $35.67 / $60.14	Professional	TC	$19.11	$35.67	$60.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $121.82 / $155.71	Professional		$119.70	$121.82	$155.71
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.08 / $86.24 / $110.60	Professional	26	$85.08	$86.24	$110.60
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $35.70 / $45.13	Professional	TC	$34.29	$35.70	$45.13
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $98.17 / $114.60	Professional		$34.00	$98.17	$114.60
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.01 / $71.78 / $83.44	Professional	26	$61.01	$71.78	$83.44
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.43 / $26.39 / $31.33	Professional	TC	$22.43	$26.39	$31.33
United Facility/Professional Professional Modifier Low / Median / High Price $62.74 / $84.16 / $171.54	Professional		$62.74	$84.16	$171.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.56 / $65.25 / $125.64	Professional	26	$44.56	$65.25	$125.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.72 / $23.97 / $54.90	Professional	TC	$14.72	$23.97	$54.90