Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.57 / $86.50 / $227.93	Facility	26	$56.57	$86.50	$227.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.39 / $294.49 / $878.92	Professional		$181.39	$294.49	$878.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.17 / $56.58 / $158.43	Professional	26	$46.17	$56.58	$158.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.22 / $237.90 / $720.49	Professional	TC	$135.22	$237.90	$720.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $134.66 / $199.63	Professional		$63.16	$134.66	$199.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.69 / $61.44 / $175.42	Professional	26	$40.69	$61.44	$175.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.32 / $351.08 / $509.06	Professional		$164.32	$351.08	$509.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.05 / $113.34 / $160.28	Professional	26	$53.05	$113.34	$160.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.27 / $237.74 / $340.89	Professional	TC	$111.27	$237.74	$340.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.66 / $73.66 / $73.66	Facility	26	$73.66	$73.66	$73.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.14 / $392.72 / $718.93	Professional		$226.14	$392.72	$718.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.00 / $112.35 / $174.20	Professional	26	$68.00	$112.35	$174.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.36 / $269.54 / $593.91	Professional	TC	$155.36	$269.54	$593.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $188.11 / $330.38 / $619.65	Professional		$188.11	$330.38	$619.65
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $107.93 / $200.05	Professional	26	$60.73	$107.93	$200.05
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $127.38 / $226.38 / $419.60	Professional	TC	$127.38	$226.38	$419.60
United Facility/Professional Professional Modifier Low / Median / High Price $246.67 / $334.42 / $530.47	Professional		$246.67	$334.42	$530.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $83.93 / $167.21	Professional	26	$56.92	$83.93	$167.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.20 / $193.32 / $459.44	Professional	TC	$169.20	$193.32	$459.44
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $156.63 / $215.52 / $306.85	Professional		$156.63	$215.52	$306.85
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $47.64 / $57.11 / $77.26	Professional	26	$47.64	$57.11	$77.26
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $108.64 / $134.71 / $244.09	Professional	TC	$108.64	$134.71	$244.09