Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.29 / $83.29 / $120.32	Facility	26	$83.29	$83.29	$120.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.91 / $220.30 / $350.08	Professional		$184.91	$220.30	$350.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.40 / $75.98 / $120.32	Professional	26	$60.40	$75.98	$120.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.04 / $148.83 / $220.68	Professional	TC	$115.04	$148.83	$220.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.27 / $278.89 / $608.07	Professional		$190.27	$278.89	$608.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $98.00 / $194.70	Professional	26	$66.73	$98.00	$194.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.61 / $180.99 / $398.75	Professional	TC	$114.61	$180.99	$398.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $226.21 / $358.68	Professional		$145.00	$226.21	$358.68
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.95 / $97.68 / $199.88	Professional	26	$72.95	$97.68	$199.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.37 / $179.06 / $368.17	Professional	TC	$134.37	$179.06	$368.17
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.78 / $179.04 / $316.56	Professional		$145.78	$179.04	$316.56
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.85 / $66.09 / $205.71	Professional	26	$54.85	$66.09	$205.71
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.33 / $120.35 / $209.25	Professional	TC	$97.33	$120.35	$209.25
United Facility/Professional Professional Modifier Low / Median / High Price $143.29 / $213.14 / $442.47	Professional		$143.29	$213.14	$442.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.04 / $82.51 / $165.18	Professional	26	$60.04	$82.51	$165.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.46 / $148.38 / $290.58	Professional	TC	$98.46	$148.38	$290.58