Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $87.10 / $229.09	Facility	26	$56.23	$87.10	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $616.60	Professional		$165.96	$257.04	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $57.54 / $165.96	Professional	26	$50.12	$57.54	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $181.97 / $436.52	Professional	TC	$114.82	$181.97	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $117.49 / $275.42	Professional		$60.26	$117.49	$275.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $67.61 / $81.28	Professional	26	$40.74	$67.61	$81.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	TC	$66.07	$66.07	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $389.05 / $588.84	Professional		$165.96	$389.05	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $123.03 / $177.83	Professional	26	$53.70	$123.03	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $263.03 / $416.87	Professional	TC	$112.20	$263.03	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $758.58	Professional		$229.09	$416.87	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $181.97	Professional	26	$69.18	$117.49	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $281.84 / $602.56	Professional	TC	$158.49	$281.84	$602.56
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $457.09	Professional		$190.55	$302.00	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $97.72 / $144.54	Professional	26	$61.66	$97.72	$144.54
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $302.00	Professional	TC	$131.83	$204.17	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $562.34	Professional		$199.53	$309.03	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $83.18 / $154.88	Professional	26	$58.88	$83.18	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $204.17 / $380.19	Professional	TC	$134.90	$204.17	$380.19
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $40.74 / $40.74	Facility	26	$34.67	$40.74	$40.74