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 $151.36 / $223.87 / $436.52	Professional		$151.36	$223.87	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $190.55	Professional	26	$54.95	$81.28	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $138.04 / $302.00	Professional	TC	$91.20	$138.04	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $194.98 / $194.98	Professional	26	$75.86	$194.98	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $346.74 / $501.19	Professional		$151.36	$346.74	$501.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $138.04 / $194.98	Professional	26	$58.88	$138.04	$194.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $208.93 / $323.59	Professional	TC	$91.20	$208.93	$323.59
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 $204.17 / $371.54 / $630.96	Professional		$204.17	$371.54	$630.96
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 $125.89 / $234.42 / $467.74	Professional	TC	$125.89	$234.42	$467.74
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $407.38	Professional		$173.78	$269.15	$407.38
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $107.15 / $154.88	Professional	26	$67.61	$107.15	$154.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $162.18 / $245.47	Professional	TC	$104.71	$162.18	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $489.78	Professional		$165.96	$251.19	$489.78
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 $104.71 / $162.18 / $302.00	Professional	TC	$104.71	$162.18	$302.00
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