Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.99 / $36.99 / $36.99	Facility	26	$36.99	$36.99	$36.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $92.76 / $140.44	Professional		$63.82	$92.76	$140.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $34.35 / $48.51	Professional	26	$28.14	$34.35	$48.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $60.20 / $86.77	Professional	TC	$29.49	$60.20	$86.77
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Professional		$82.00	$82.00	$82.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.64 / $37.64 / $37.64	Facility	26	$37.64	$37.64	$37.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.88 / $107.36 / $215.10	Professional		$55.88	$107.36	$215.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $46.63 / $85.44	Professional	26	$25.30	$46.63	$85.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $68.28 / $141.47	Professional	TC	$24.75	$68.28	$141.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.83 / $154.52 / $200.82	Professional		$118.83	$154.52	$200.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.27 / $49.21 / $64.11	Professional	26	$38.27	$49.21	$64.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.56 / $105.37 / $136.72	Professional	TC	$80.56	$105.37	$136.72
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.83 / $82.37 / $137.71	Professional		$53.83	$82.37	$137.71
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.71 / $32.25 / $80.43	Professional	26	$26.71	$32.25	$80.43
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.08 / $59.45 / $100.05	Professional	TC	$48.08	$59.45	$100.05
United Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $106.01 / $200.89	Professional		$53.77	$106.01	$200.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.68 / $38.09 / $67.41	Professional	26	$24.68	$38.09	$67.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.05 / $60.89 / $119.27	Professional	TC	$29.05	$60.89	$119.27