Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $89.13 / $234.42	Facility	26	$57.54	$89.13	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $223.87 / $398.11	Professional		$158.49	$223.87	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $186.21	Professional	26	$54.95	$85.11	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $151.36 / $295.12	Professional	TC	$97.72	$151.36	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $380.19	Professional		$123.03	$123.03	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $194.98	Professional	26	$47.86	$47.86	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $371.54 / $537.03	Professional		$158.49	$371.54	$537.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $138.04 / $199.53	Professional	26	$58.88	$138.04	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $229.09 / $338.84	Professional	TC	$100.00	$229.09	$338.84
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 $218.78 / $389.05 / $758.58	Professional		$218.78	$389.05	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $123.03 / $181.97	Professional	26	$75.86	$123.03	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $263.03 / $602.56	Professional	TC	$138.04	$263.03	$602.56
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $416.87	Professional		$173.78	$281.84	$416.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $102.33 / $158.49	Professional	26	$67.61	$102.33	$158.49
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $186.21 / $263.03	Professional	TC	$117.49	$186.21	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $549.54	Professional		$194.98	$288.40	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $85.11 / $158.49	Professional	26	$60.26	$85.11	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $194.98 / $389.05	Professional	TC	$125.89	$194.98	$389.05
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $45.71 / $45.71	Facility	26	$38.90	$45.71	$45.71