Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.14 / $91.25 / $235.15	Facility	26	$58.14	$91.25	$235.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.15 / $242.68 / $721.63	Professional		$145.15	$242.68	$721.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.48 / $58.14 / $162.74	Professional	26	$47.48	$58.14	$162.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.67 / $184.55 / $558.89	Professional	TC	$97.67	$184.55	$558.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.81 / $379.80 / $379.80	Professional		$120.81	$379.80	$379.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.83 / $48.95 / $193.54	Professional	26	$46.83	$48.95	$193.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.56 / $334.49 / $479.62	Professional		$156.56	$334.49	$479.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.55 / $125.09 / $176.90	Professional	26	$58.55	$125.09	$176.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.01 / $209.40 / $303.63	Professional	TC	$98.01	$209.40	$303.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.93 / $75.93 / $75.93	Facility	26	$75.93	$75.93	$75.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.16 / $373.17 / $696.87	Professional		$216.16	$373.17	$696.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.29 / $123.25 / $180.93	Professional	26	$74.29	$123.25	$180.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.88 / $241.95 / $528.97	Professional	TC	$136.88	$241.95	$528.97
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $179.23 / $310.02 / $590.40	Professional		$179.23	$310.02	$590.40
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $67.02 / $119.11 / $220.77	Professional	26	$67.02	$119.11	$220.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $199.40 / $369.60	Professional	TC	$112.20	$199.40	$369.60
United Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $291.07 / $1,212.92	Professional		$250.00	$291.07	$1,212.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.65 / $84.92 / $171.94	Professional	26	$58.65	$84.92	$171.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.01 / $197.45 / $465.37	Professional	TC	$144.01	$197.45	$465.37
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $191.46 / $298.33	Professional		$139.13	$191.46	$298.33
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $48.70 / $58.37 / $78.97	Professional	26	$48.70	$58.37	$78.97
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.09 / $108.11 / $240.42	Professional	TC	$90.09	$108.11	$240.42