Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $95.50 / $95.50	Facility	26	$52.48	$95.50	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $302.00	Professional		$162.18	$194.98	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $281.84 / $524.81	Professional		$144.54	$281.84	$524.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $338.84 / $398.11	Professional		$309.03	$338.84	$398.11
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $562.34	Professional		$177.83	$223.87	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $407.38	Professional		$120.23	$213.80	$407.38