Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $91.20 / $234.42	Facility	26	$57.54	$91.20	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $602.56	Professional		$173.78	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $186.21	Professional	26	$54.95	$83.18	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $158.49 / $295.12	Professional	TC	$112.20	$158.49	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	26	$46.77	$46.77	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $407.38 / $645.65	Professional		$173.78	$407.38	$645.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $134.90 / $194.98	Professional	26	$58.88	$134.90	$194.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $263.03 / $426.58	Professional	TC	$114.82	$263.03	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Facility	26	$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $416.87 / $776.25	Professional		$234.42	$416.87	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $123.03 / $186.21	Professional	26	$75.86	$123.03	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $281.84 / $602.56	Professional	TC	$158.49	$281.84	$602.56
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $316.23 / $478.63	Professional		$204.17	$316.23	$478.63
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $104.71 / $154.88	Professional	26	$67.61	$104.71	$154.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $302.00	Professional	TC	$134.90	$208.93	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $309.03 / $524.81	Professional		$194.98	$309.03	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $158.49	Professional	26	$58.88	$85.11	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $354.81	Professional	TC	$131.83	$204.17	$354.81
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $44.67 / $44.67	Facility	26	$38.02	$44.67	$44.67