Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.00 / $30.00 / $30.00	Facility	26	$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.30 / $153.52 / $197.49	Professional		$109.30	$153.52	$197.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.29 / $127.06 / $159.74	Professional	TC	$87.29	$127.06	$159.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.88 / $30.88 / $30.88	Facility	26	$30.88	$30.88	$30.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.86 / $183.00 / $365.00	Professional		$98.86	$183.00	$365.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.73 / $163.94 / $316.37	Professional	TC	$79.73	$163.94	$316.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $208.64 / $271.79 / $353.54	Professional		$208.64	$271.79	$353.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.48 / $232.95 / $303.10	Professional	TC	$178.48	$232.95	$303.10
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.45 / $130.97 / $220.66	Professional		$106.45	$130.97	$220.66
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.76 / $106.01 / $184.29	Professional	TC	$85.76	$106.01	$184.29
United Facility/Professional Professional Modifier Low / Median / High Price $104.17 / $159.77 / $307.97	Professional		$104.17	$159.77	$307.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.01 / $128.21 / $212.64	Professional	TC	$87.01	$128.21	$212.64