Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.08 / $25.09 / $25.09	Facility	26	$25.08	$25.09	$25.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $46.77 / $79.31	Professional		$32.18	$46.77	$79.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $22.19 / $34.14	Professional	26	$18.04	$22.19	$34.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.15 / $21.78 / $45.50	Professional	TC	$14.15	$21.78	$45.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $81.25 / $81.25	Professional		$81.25	$81.25	$81.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.57 / $68.67 / $129.37	Professional		$45.57	$68.67	$129.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.93 / $29.68 / $63.29	Professional	26	$19.93	$29.68	$63.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $39.84 / $73.97	Professional	TC	$20.67	$39.84	$73.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.02 / $84.04 / $172.67	Professional		$63.02	$84.04	$172.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.64 / $29.04 / $59.29	Professional	26	$21.64	$29.04	$59.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.37 / $54.99 / $113.35	Professional	TC	$41.37	$54.99	$113.35
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.83 / $39.42 / $73.02	Professional		$26.83	$39.42	$73.02
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $20.54 / $48.11	Professional	26	$16.32	$20.54	$48.11
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $28.43 / $48.60	Professional	TC	$23.00	$28.43	$48.60
United Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $50.74 / $95.08	Professional		$34.54	$50.74	$95.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $22.87 / $45.73	Professional	26	$13.70	$22.87	$45.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $30.23 / $55.61	Professional	TC	$17.37	$30.23	$55.61