Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.07 / $91.48 / $240.49	Facility	26	$59.07	$91.48	$240.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.30 / $293.12 / $892.76	Professional		$132.30	$293.12	$892.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.91 / $59.08 / $165.38	Professional	26	$41.91	$59.08	$165.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.39 / $240.16 / $727.35	Professional	TC	$90.39	$240.16	$727.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.73 / $363.65 / $363.65	Professional		$80.73	$363.65	$363.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $66.20 / $170.03	Professional	26	$41.11	$66.20	$170.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.76 / $319.98 / $458.81	Professional		$149.76	$319.98	$458.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $109.88 / $155.38	Professional	26	$51.43	$109.88	$155.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.33 / $210.09 / $297.10	Professional	TC	$98.33	$210.09	$297.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.91 / $76.91 / $76.91	Facility	26	$76.91	$76.91	$76.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.30 / $356.03 / $651.48	Professional		$199.30	$356.03	$651.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.88 / $109.37 / $160.52	Professional	26	$65.88	$109.37	$160.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.07 / $238.06 / $513.15	Professional	TC	$132.07	$238.06	$513.15
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $171.45 / $304.70 / $564.77	Professional		$171.45	$304.70	$564.77
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $104.64 / $193.96	Professional	26	$58.88	$104.64	$193.96
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $112.57 / $200.06 / $370.82	Professional	TC	$112.57	$200.06	$370.82
United Facility/Professional Professional Modifier Low / Median / High Price $209.89 / $254.43 / $460.45	Professional		$209.89	$254.43	$460.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.77 / $75.06 / $151.97	Professional	26	$59.77	$75.06	$151.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.52 / $167.82 / $307.67	Professional	TC	$124.52	$167.82	$307.67
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $133.18 / $183.26 / $301.88	Professional		$133.18	$183.26	$301.88
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $43.37 / $53.78 / $75.33	Professional	26	$43.37	$53.78	$75.33
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $89.80 / $107.76 / $242.99	Professional	TC	$89.80	$107.76	$242.99