Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.06 / $71.06 / $99.49	Facility	26	$71.06	$71.06	$99.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.22 / $240.73 / $458.67	Professional		$205.22	$240.73	$458.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $69.17 / $146.55	Professional	26	$56.37	$69.17	$146.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.71 / $169.66 / $299.16	Professional	TC	$142.71	$169.66	$299.16
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $65.44 / $266.89 / $266.89	Professional		$65.44	$266.89	$266.89
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $71.58 / $140.08 / $177.89	Professional	26	$71.58	$140.08	$177.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.66 / $310.44 / $623.17	Professional		$227.66	$310.44	$623.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.38 / $86.38 / $167.98	Professional	26	$59.38	$86.38	$167.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.85 / $227.76 / $449.48	Professional	TC	$163.85	$227.76	$449.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $246.29 / $328.33 / $674.83	Professional		$246.29	$328.33	$674.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.11 / $87.02 / $178.40	Professional	26	$65.11	$87.02	$178.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.18 / $241.33 / $496.43	Professional	TC	$181.18	$241.33	$496.43
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.19 / $231.15 / $339.68	Professional		$188.19	$231.15	$339.68
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.15 / $59.22 / $219.30	Professional	26	$49.15	$59.22	$219.30
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.04 / $171.93 / $298.93	Professional	TC	$139.04	$171.93	$298.93
United Facility/Professional Professional Modifier Low / Median / High Price $201.32 / $264.70 / $530.15	Professional		$201.32	$264.70	$530.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.52 / $76.29 / $136.59	Professional	26	$55.52	$76.29	$136.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.69 / $201.75 / $394.11	Professional	TC	$147.69	$201.75	$394.11