Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.50 / $208.11 / $208.11	Facility	26	$73.50	$208.11	$208.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.06 / $232.72 / $722.66	Professional		$127.06	$232.72	$722.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.91 / $51.16 / $143.19	Professional	26	$41.91	$51.16	$143.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.15 / $184.15 / $579.46	Professional	TC	$85.15	$184.15	$579.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.33 / $56.33 / $56.33	Professional		$56.33	$56.33	$56.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $66.20 / $66.20	Professional	26	$41.11	$66.20	$66.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.21 / $312.38 / $447.92	Professional		$146.21	$312.38	$447.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $109.88 / $155.38	Professional	26	$51.43	$109.88	$155.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.78 / $202.49 / $286.36	Professional	TC	$94.78	$202.49	$286.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.23 / $67.23 / $67.23	Facility	26	$67.23	$67.23	$67.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.51 / $346.91 / $620.42	Professional		$194.51	$346.91	$620.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.48 / $108.35 / $158.94	Professional	26	$65.48	$108.35	$158.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.28 / $228.17 / $476.28	Professional	TC	$127.28	$228.17	$476.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $167.38 / $297.47 / $551.37	Professional		$167.38	$297.47	$551.37
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $104.64 / $193.96	Professional	26	$58.88	$104.64	$193.96
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $108.50 / $192.83 / $357.41	Professional	TC	$108.50	$192.83	$357.41
United Facility/Professional Professional Modifier Low / Median / High Price $204.92 / $248.48 / $441.43	Professional		$204.92	$248.48	$441.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.77 / $75.06 / $151.97	Professional	26	$51.77	$75.06	$151.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $157.38 / $289.45	Professional	TC	$134.90	$157.38	$289.45
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $129.99 / $178.87 / $247.96	Professional		$129.99	$178.87	$247.96
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $43.06 / $51.61 / $69.81	Professional	26	$43.06	$51.61	$69.81
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $86.62 / $103.94 / $196.79	Professional	TC	$86.62	$103.94	$196.79