Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.37 / $83.37 / $104.18	Facility	26	$83.37	$83.37	$104.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.84 / $442.07 / $625.69	Professional		$354.84	$442.07	$625.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.32 / $61.78 / $85.39	Professional	26	$50.32	$61.78	$85.39
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $177.42 / $218.32 / $291.50	Professional	52	$177.42	$218.32	$291.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.45 / $377.82 / $522.76	Professional	TC	$299.45	$377.82	$522.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.83 / $629.28 / $1,233.08	Professional		$301.83	$629.28	$1,233.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.26 / $87.76 / $153.05	Professional	26	$43.26	$87.76	$153.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.57 / $544.53 / $1,080.04	Professional	TC	$258.57	$544.53	$1,080.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $490.13 / $637.94 / $830.71	Professional		$490.13	$637.94	$830.71
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.79 / $83.47 / $108.09	Professional	26	$64.79	$83.47	$108.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $425.34 / $554.47 / $722.62	Professional	TC	$425.34	$554.47	$722.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.19 / $404.36 / $791.93	Professional		$327.19	$404.36	$791.93
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.88 / $56.46 / $138.03	Professional	26	$46.88	$56.46	$138.03
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $280.31 / $346.54 / $588.29	Professional	TC	$280.31	$346.54	$588.29
United Facility/Professional Professional Modifier Low / Median / High Price $306.72 / $463.77 / $947.65	Professional		$306.72	$463.77	$947.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.50 / $68.02 / $129.16	Professional	26	$45.50	$68.02	$129.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $285.18 / $397.32 / $814.89	Professional	TC	$285.18	$397.32	$814.89