Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.68 / $43.82	Facility	26	$34.67	$34.68	$43.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $125.74 / $207.52	Professional		$95.27	$125.74	$207.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.27 / $29.27 / $43.82	Professional	26	$22.27	$29.27	$43.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $99.53 / $144.13	Professional	TC	$65.98	$99.53	$144.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.65 / $243.56 / $462.43	Professional		$149.65	$243.56	$462.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.47 / $38.22 / $67.01	Professional	26	$21.47	$38.22	$67.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.09 / $195.56 / $366.74	Professional	TC	$123.09	$195.56	$366.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $167.04 / $222.06 / $457.69	Professional		$167.04	$222.06	$457.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.88 / $51.31 / $106.53	Professional	26	$38.88	$51.31	$106.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.16 / $170.74 / $351.16	Professional	TC	$128.16	$170.74	$351.16
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.62 / $138.16 / $247.88	Professional		$109.62	$138.16	$247.88
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $24.20 / $93.16	Professional	26	$20.57	$24.20	$93.16
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.54 / $110.71 / $192.44	Professional	TC	$89.54	$110.71	$192.44
United Facility/Professional Professional Modifier Low / Median / High Price $126.06 / $185.21 / $340.90	Professional		$126.06	$185.21	$340.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $29.16 / $54.14	Professional	26	$24.19	$29.16	$54.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.64 / $158.53 / $318.67	Professional	TC	$100.64	$158.53	$318.67