Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.59 / $84.60 / $84.60	Facility	26	$84.59	$84.60	$84.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.52 / $152.77 / $245.66	Professional		$127.52	$152.77	$245.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.64 / $82.02 / $115.74	Professional	26	$66.64	$82.02	$115.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.14 / $77.72 / $129.97	Professional	TC	$49.14	$77.72	$129.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.51 / $86.51 / $86.51	Facility	26	$86.51	$86.51	$86.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.56 / $205.16 / $395.47	Professional		$106.56	$205.16	$395.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.74 / $111.82 / $205.81	Professional	26	$59.74	$111.82	$205.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.15 / $116.04 / $223.24	Professional	TC	$47.15	$116.04	$223.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $178.85 / $232.15 / $540.04	Professional		$178.85	$232.15	$540.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.58 / $115.35 / $540.04	Professional	26	$89.58	$115.35	$540.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.27 / $116.79 / $540.04	Professional	TC	$89.27	$116.79	$540.04
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.02 / $159.93 / $254.59	Professional		$101.02	$159.93	$254.59
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.65 / $76.86 / $135.94	Professional	26	$63.65	$76.86	$135.94
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.30 / $89.40 / $154.63	Professional	TC	$72.30	$89.40	$154.63
United Facility/Professional Professional Modifier Low / Median / High Price $99.49 / $189.44 / $335.46	Professional		$99.49	$189.44	$335.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.32 / $92.60 / $161.18	Professional	26	$59.32	$92.60	$161.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.70 / $102.46 / $194.38	Professional	TC	$48.70	$102.46	$194.38