Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $39.81 / $141.25	Facility	26	$19.05	$39.81	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $81.28	Professional		$42.66	$52.48	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $25.70	Professional	26	$12.88	$15.14	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $37.15 / $57.54	Professional	TC	$28.84	$37.15	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $74.13 / $162.18	Professional		$47.86	$74.13	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.38 / $45.71	Professional	26	$14.13	$21.38	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $53.70 / $114.82	Professional	TC	$33.88	$53.70	$114.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $61.66 / $83.18	Professional		$46.77	$61.66	$83.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.95 / $28.18	Professional	26	$14.79	$19.95	$28.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $41.69 / $54.95	Professional	TC	$31.62	$41.69	$54.95
Horizon BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $134.90	Professional		$43.65	$54.95	$134.90
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $38.02	Professional	26	$12.02	$15.14	$38.02
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $39.81 / $97.72	Professional	TC	$31.62	$39.81	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $58.88 / $109.65	Professional		$33.11	$58.88	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.22 / $30.90	Professional	26	$10.23	$16.22	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $42.66 / $81.28	Professional	TC	$22.39	$42.66	$81.28