Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.40 / $59.81 / $157.22	Facility	26	$38.40	$59.81	$157.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $186.09 / $554.72	Professional		$90.81	$186.09	$554.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.57 / $38.40 / $107.50	Professional	26	$31.57	$38.40	$107.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.24 / $147.68 / $447.21	Professional	TC	$59.24	$147.68	$447.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $86.04 / $255.11	Professional		$81.06	$86.04	$255.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $42.02 / $128.28	Professional	26	$29.75	$42.02	$128.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.13 / $224.61 / $322.06	Professional		$105.13	$224.61	$322.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $82.93 / $117.27	Professional	26	$38.82	$82.93	$117.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.31 / $141.68 / $203.15	Professional	TC	$66.31	$141.68	$203.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.79 / $50.79 / $50.79	Facility	26	$50.79	$50.79	$50.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.81 / $247.90 / $473.83	Professional		$139.81	$247.90	$473.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.51 / $81.30 / $119.01	Professional	26	$49.51	$81.30	$119.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.08 / $159.00 / $364.52	Professional	TC	$89.08	$159.00	$364.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $120.35 / $213.89 / $396.44	Professional		$120.35	$213.89	$396.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.44 / $78.98 / $146.38	Professional	26	$44.44	$78.98	$146.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $75.91 / $134.91 / $250.06	Professional	TC	$75.91	$134.91	$250.06
United Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $186.64 / $356.54	Professional		$128.77	$186.64	$356.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.71 / $56.77 / $254.76	Professional	26	$41.71	$56.77	$254.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.03 / $111.20 / $210.30	Professional	TC	$92.03	$111.20	$210.30
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $91.84 / $126.37 / $190.60	Professional		$91.84	$126.37	$190.60
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $32.52 / $38.99 / $52.74	Professional	26	$32.52	$38.99	$52.74
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $59.08 / $70.90 / $152.05	Professional	TC	$59.08	$70.90	$152.05