Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.49 / $81.45 / $213.37	Facility	26	$46.49	$81.45	$213.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.46 / $231.03 / $689.27	Professional		$135.46	$231.03	$689.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $46.49 / $130.38	Professional	26	$37.79	$46.49	$130.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $67.73 / $84.39 / $160.00	Professional	52	$67.73	$84.39	$160.00
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 $101.01 / $107.20 / $317.87	Professional		$101.01	$107.20	$317.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $56.82 / $162.50	Professional	26	$37.88	$56.82	$162.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.66 / $67.66 / $67.66	Professional	TC	$67.66	$67.66	$67.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $279.89 / $405.85	Professional		$131.00	$279.89	$405.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.17 / $105.05 / $148.56	Professional	26	$49.17	$105.05	$148.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.84 / $174.85 / $250.71	Professional	TC	$81.84	$174.85	$250.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.83 / $68.83 / $68.83	Facility	26	$68.83	$68.83	$68.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.31 / $311.91 / $607.34	Professional		$179.31	$311.91	$607.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $104.53 / $151.91	Professional	26	$62.95	$104.53	$151.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.34 / $197.61 / $475.59	Professional	TC	$114.34	$197.61	$475.59
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $259.42 / $494.02	Professional		$149.97	$259.42	$494.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $56.29 / $97.37 / $185.42	Professional	26	$56.29	$97.37	$185.42
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $93.69 / $166.15 / $308.62	Professional	TC	$93.69	$166.15	$308.62
United Facility/Professional Professional Modifier Low / Median / High Price $198.55 / $239.92 / $491.61	Professional		$198.55	$239.92	$491.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.89 / $76.54 / $136.94	Professional	26	$52.89	$76.54	$136.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.78 / $153.19 / $610.17	Professional	TC	$126.78	$153.19	$610.17
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $125.86 / $173.18 / $249.49	Professional		$125.86	$173.18	$249.49
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $52.91 / $66.87	Professional	26	$44.14	$52.91	$66.87
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $62.29 / $74.75 / $84.09	Professional	52	$62.29	$74.75	$84.09
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $81.40 / $100.94 / $196.79	Professional	TC	$81.40	$100.94	$196.79