Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $325.06 / $342.51 / $8,717.15	Facility	26	$325.06	$342.51	$8,717.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $968.78 / $1,133.92 / $1,701.00	Professional		$968.78	$1,133.92	$1,701.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $272.11 / $312.27 / $403.65	Professional	26	$272.11	$312.27	$403.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $682.87 / $815.25 / $1,153.74	Professional	TC	$682.87	$815.25	$1,153.74
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $224.54 / $224.54 / $224.54	Professional		$224.54	$224.54	$224.54
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $253.61 / $253.61 / $411.75	Professional	26	$253.61	$253.61	$411.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,126.10 / $1,622.12 / $3,571.71	Professional		$1,126.10	$1,622.12	$3,571.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $299.20 / $467.18 / $960.14	Professional	26	$299.20	$467.18	$960.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $816.29 / $1,174.84 / $2,591.82	Professional	TC	$816.29	$1,174.84	$2,591.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,512.59 / $1,666.71 / $1,854.84	Professional		$1,512.59	$1,666.71	$1,854.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $412.37 / $474.22 / $527.75	Professional	26	$412.37	$474.22	$527.75
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,100.23 / $1,192.49 / $1,327.10	Professional	TC	$1,100.23	$1,192.49	$1,327.10
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $867.23 / $1,064.54 / $1,556.67	Professional		$867.23	$1,064.54	$1,556.67
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $230.11 / $270.72 / $1,200.58	Professional	26	$230.11	$270.72	$1,200.58
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $637.12 / $749.55 / $1,352.94	Professional	TC	$637.12	$749.55	$1,352.94
United Facility/Professional Professional Modifier Low / Median / High Price $908.47 / $1,287.49 / $2,501.76	Professional		$908.47	$1,287.49	$2,501.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $253.70 / $352.22 / $644.92	Professional	26	$253.70	$352.22	$644.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $670.27 / $940.86 / $1,861.50	Professional	TC	$670.27	$940.86	$1,861.50