Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.91 / $436.78 / $693.59	Professional		$324.91	$436.78	$693.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.25 / $172.71 / $196.10	Professional	26	$119.25	$172.71	$196.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.28 / $349.93 / $525.54	Professional	TC	$173.28	$349.93	$525.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $332.48 / $332.48 / $332.48	Professional		$332.48	$332.48	$332.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $385.58 / $443.42 / $606.32	Professional		$385.58	$443.42	$606.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $177.88 / $204.56 / $279.72	Professional	26	$177.88	$204.56	$279.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.71 / $238.87 / $326.62	Professional	TC	$207.71	$238.87	$326.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.64 / $322.98 / $335.22	Professional		$183.64	$322.98	$335.22
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.86 / $166.89 / $171.18	Professional	26	$141.86	$166.89	$171.18
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.68 / $156.09 / $164.05	Professional	TC	$132.68	$156.09	$164.05
United Facility/Professional Professional Modifier Low / Median / High Price $179.36 / $341.98 / $695.80	Professional		$179.36	$341.98	$695.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.19 / $127.48 / $222.60	Professional	26	$81.19	$127.48	$222.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.38 / $165.27 / $354.92	Professional	TC	$93.38	$165.27	$354.92