Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.52 / $106.52 / $106.52	Facility	26	$106.52	$106.52	$106.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.90 / $290.61 / $456.65	Professional		$230.90	$290.61	$456.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $102.73 / $145.08	Professional	26	$84.34	$102.73	$145.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.69 / $188.48 / $330.97	Professional	TC	$146.69	$188.48	$330.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.62 / $110.62 / $110.62	Facility	26	$110.62	$110.62	$110.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.18 / $392.29 / $797.23	Professional		$199.18	$392.29	$797.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.33 / $141.15 / $259.17	Professional	26	$74.33	$141.15	$259.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.54 / $256.87 / $541.16	Professional	TC	$124.54	$256.87	$541.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $339.97 / $442.21 / $574.30	Professional		$339.97	$442.21	$574.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.38 / $144.86 / $187.93	Professional	26	$112.38	$144.86	$187.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $227.59 / $297.33 / $386.36	Professional	TC	$227.59	$297.33	$386.36
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.60 / $238.79 / $436.21	Professional		$178.60	$238.79	$436.21
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.18 / $95.55 / $172.27	Professional	26	$79.18	$95.55	$172.27
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.79 / $153.06 / $264.77	Professional	TC	$123.79	$153.06	$264.77
United Facility/Professional Professional Modifier Low / Median / High Price $178.17 / $295.06 / $568.79	Professional		$178.17	$295.06	$568.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.53 / $115.12 / $218.61	Professional	26	$74.53	$115.12	$218.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.85 / $185.67 / $360.44	Professional	TC	$133.85	$185.67	$360.44