Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.39 / $61.39 / $101.10	Facility	26	$61.39	$61.39	$101.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.30 / $178.34 / $300.29	Professional		$135.30	$178.34	$300.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.46 / $59.03 / $101.10	Professional	26	$53.46	$59.03	$101.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.36 / $116.95 / $199.18	Professional	TC	$84.36	$116.95	$199.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.49 / $388.85 / $836.18	Professional		$284.49	$388.85	$836.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.58 / $76.28 / $144.97	Professional	26	$49.58	$76.28	$144.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.96 / $322.00 / $698.70	Professional	TC	$225.96	$322.00	$698.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $191.44 / $254.78 / $524.54	Professional		$191.44	$254.78	$524.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.28 / $84.04 / $173.39	Professional	26	$63.28	$84.04	$173.39
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 $135.22 / $165.81 / $278.48	Professional		$135.22	$165.81	$278.48
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.07 / $56.71 / $189.86	Professional	26	$47.07	$56.71	$189.86
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.87 / $110.43 / $194.30	Professional	TC	$93.87	$110.43	$194.30
United Facility/Professional Professional Modifier Low / Median / High Price $211.93 / $328.05 / $640.74	Professional		$211.93	$328.05	$640.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.22 / $65.11 / $126.70	Professional	26	$42.22	$65.11	$126.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.81 / $276.70 / $523.79	Professional	TC	$178.81	$276.70	$523.79