Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.53 / $96.51 / $253.66	Facility	26	$62.53	$96.51	$253.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.98 / $293.00 / $872.97	Professional		$185.98	$293.00	$872.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.34 / $62.53 / $175.00	Professional	26	$51.34	$62.53	$175.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.63 / $230.46 / $697.97	Professional	TC	$134.63	$230.46	$697.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $439.84 / $439.84	Professional		$139.44	$439.84	$439.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.15 / $80.77 / $207.44	Professional	26	$50.15	$80.77	$207.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.14 / $387.02 / $561.16	Professional		$181.14	$387.02	$561.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.75 / $134.07 / $189.60	Professional	26	$62.75	$134.07	$189.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.39 / $252.94 / $362.69	Professional	TC	$118.39	$252.94	$362.69
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 $241.06 / $431.78 / $741.65	Professional		$241.06	$431.78	$741.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.76 / $132.77 / $193.97	Professional	26	$79.76	$132.77	$193.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.02 / $287.17 / $524.21	Professional	TC	$159.02	$287.17	$524.21
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $203.24 / $341.85 / $683.10	Professional		$203.24	$341.85	$683.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $118.18 / $236.65	Professional	26	$71.84	$118.18	$236.65
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $135.53 / $240.86 / $446.45	Professional	TC	$135.53	$240.86	$446.45
United Facility/Professional Professional Modifier Low / Median / High Price $254.53 / $295.33 / $648.41	Professional		$254.53	$295.33	$648.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.76 / $91.96 / $186.03	Professional	26	$64.76	$91.96	$186.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.74 / $202.46 / $460.53	Professional	TC	$168.74	$202.46	$460.53
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $161.50 / $222.22 / $314.81	Professional		$161.50	$222.22	$314.81
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $52.77 / $63.25 / $85.57	Professional	26	$52.77	$63.25	$85.57
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $108.35 / $134.35 / $233.82	Professional	TC	$108.35	$134.35	$233.82