Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $110.21 / $147.29	Professional		$88.43	$110.21	$147.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $15.12 / $20.30	Professional	26	$12.60	$15.12	$20.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $96.59 / $127.83	Professional	TC	$75.26	$96.59	$127.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.02 / $136.68 / $240.57	Professional		$86.02	$136.68	$240.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.33 / $16.73 / $29.30	Professional	26	$12.33	$16.73	$29.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.94 / $121.06 / $209.55	Professional	TC	$74.94	$121.06	$209.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $160.79 / $204.10	Professional		$155.40	$160.79	$204.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.84 / $21.40	Professional	26	$16.60	$16.84	$21.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.63 / $143.94 / $182.69	Professional	TC	$138.63	$143.94	$182.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.90 / $105.76 / $142.86	Professional		$89.90	$105.76	$142.86
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $13.64 / $15.81	Professional	26	$11.59	$13.64	$15.81
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.30 / $94.19 / $110.81	Professional	TC	$78.30	$94.19	$110.81
United Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $95.71 / $156.19	Professional		$73.20	$95.71	$156.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $12.11 / $23.86	Professional	26	$9.02	$12.11	$23.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.30 / $87.48 / $165.06	Professional	TC	$59.30	$87.48	$165.06