Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $257.04 / $398.11	Facility	26	$52.48	$257.04	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $190.55	Professional		$69.18	$95.50	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $158.49	Professional	26	$38.02	$48.98	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $81.28	Professional	TC	$23.99	$42.66	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $257.04	Professional		$74.13	$107.15	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $131.83	Professional	26	$39.81	$61.66	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $47.86 / $112.20	Professional	TC	$28.84	$47.86	$112.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $173.78	Professional		$95.50	$128.82	$173.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $87.10	Professional	26	$45.71	$60.26	$87.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $87.10	Professional	TC	$50.12	$67.61	$87.10
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $165.96	Professional		$56.23	$75.86	$165.96
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $42.66 / $107.15	Professional	26	$33.88	$42.66	$107.15
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $87.10	Professional	TC	$28.84	$36.31	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $147.91	Professional		$60.26	$79.43	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $91.20	Professional	26	$30.90	$46.77	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $67.61	Professional	TC	$23.99	$36.31	$67.61