Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.82 / $115.71 / $233.85	Facility	26	$57.82	$115.71	$233.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.71 / $281.67 / $875.56	Professional		$150.71	$281.67	$875.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $57.83 / $161.90	Professional	26	$47.22	$57.83	$161.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.49 / $226.80 / $713.65	Professional	TC	$103.49	$226.80	$713.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.50 / $131.50 / $131.50	Professional		$131.50	$131.50	$131.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.33 / $48.41 / $191.37	Professional	26	$46.33	$48.41	$191.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.79 / $364.90 / $523.23	Professional		$170.79	$364.90	$523.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.90 / $123.71 / $174.95	Professional	26	$57.90	$123.71	$174.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.89 / $241.19 / $341.09	Professional	TC	$112.89	$241.19	$341.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.59 / $75.59 / $75.59	Facility	26	$75.59	$75.59	$75.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.30 / $406.30 / $743.46	Professional		$227.30	$406.30	$743.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.42 / $121.88 / $178.91	Professional	26	$73.42	$121.88	$178.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.84 / $273.48 / $569.35	Professional	TC	$151.84	$273.48	$569.35
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $195.52 / $325.54 / $644.05	Professional		$195.52	$325.54	$644.05
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $109.26 / $218.33	Professional	26	$66.28	$109.26	$218.33
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $129.22 / $229.67 / $425.70	Professional	TC	$129.22	$229.67	$425.70
United Facility/Professional Professional Modifier Low / Median / High Price $240.30 / $300.38 / $532.97	Professional		$240.30	$300.38	$532.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.49 / $97.44 / $183.67	Professional	26	$62.49	$97.44	$183.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.53 / $193.80 / $354.99	Professional	TC	$161.53	$193.80	$354.99
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $152.50 / $209.84 / $299.86	Professional		$152.50	$209.84	$299.86
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $48.43 / $58.05 / $78.53	Professional	26	$48.43	$58.05	$78.53
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $103.72 / $124.46 / $242.26	Professional	TC	$103.72	$124.46	$242.26