Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.72 / $253.66 / $253.66	Facility	26	$62.72	$253.66	$253.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.58 / $332.37 / $1,034.18	Professional		$218.58	$332.37	$1,034.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.05 / $62.73 / $175.58	Professional	26	$51.05	$62.73	$175.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $167.52 / $272.87 / $858.60	Professional	TC	$167.52	$272.87	$858.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $41.37 / $121.43	Professional	26	$41.11	$41.37	$121.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.58 / $379.41 / $550.14	Professional		$177.58	$379.41	$550.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $109.88 / $155.93	Professional	26	$51.43	$109.88	$155.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $126.15 / $269.52 / $388.03	Professional	TC	$126.15	$269.52	$388.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.55 / $81.55 / $81.55	Facility	26	$81.55	$81.55	$81.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.79 / $427.01 / $807.66	Professional		$245.79	$427.01	$807.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.23 / $109.37 / $172.10	Professional	26	$67.23	$109.37	$172.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.22 / $307.64 / $646.94	Professional	TC	$176.22	$307.64	$646.94
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $203.29 / $361.29 / $669.66	Professional		$203.29	$361.29	$669.66
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $103.41 / $193.96	Professional	26	$58.88	$103.41	$193.96
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $144.41 / $256.66 / $475.73	Professional	TC	$144.41	$256.66	$475.73
United Facility/Professional Professional Modifier Low / Median / High Price $281.64 / $328.58 / $754.23	Professional		$281.64	$328.58	$754.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.94 / $74.67 / $156.66	Professional	26	$61.94	$74.67	$156.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.68 / $241.81 / $573.00	Professional	TC	$197.68	$241.81	$573.00
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $179.26 / $246.66 / $370.28	Professional		$179.26	$246.66	$370.28
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $43.37 / $54.21 / $79.58	Professional	26	$43.37	$54.21	$79.58
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $135.88 / $168.50 / $284.06	Professional	TC	$135.88	$168.50	$284.06