Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.60 / $48.60 / $76.62	Facility	26	$48.60	$48.60	$76.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.35 / $140.85 / $170.10	Professional		$122.35	$140.85	$170.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.15 / $48.60 / $64.27	Professional	26	$40.15	$48.60	$64.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.19 / $92.25 / $108.79	Professional	TC	$82.19	$92.25	$108.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $328.85 / $328.85	Professional		$104.55	$328.85	$328.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.33 / $94.31 / $162.50	Professional	26	$39.33	$94.31	$162.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.53 / $289.57 / $415.21	Professional		$135.53	$289.57	$415.21
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 $86.37 / $184.52 / $260.94	Professional	TC	$86.37	$184.52	$260.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.24 / $294.64 / $430.44	Professional		$180.24	$294.64	$430.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $103.59 / $151.91	Professional	26	$62.95	$103.59	$151.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.98 / $191.05 / $278.52	Professional	TC	$115.98	$191.05	$278.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $155.16 / $275.16 / $511.11	Professional		$155.16	$275.16	$511.11
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $56.29 / $100.04 / $185.42	Professional	26	$56.29	$100.04	$185.42
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $98.87 / $175.71 / $325.69	Professional	TC	$98.87	$175.71	$325.69
United Facility/Professional Professional Modifier Low / Median / High Price $157.81 / $202.38 / $426.06	Professional		$157.81	$202.38	$426.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $68.36 / $120.08	Professional	26	$52.40	$68.36	$120.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.04 / $147.91 / $283.01	Professional	TC	$114.04	$147.91	$283.01
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $188.18 / $240.66 / $369.15	Professional		$188.18	$240.66	$369.15
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $48.16 / $72.73	Professional	26	$40.94	$48.16	$72.73
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $166.83 / $196.27 / $296.42	Professional	TC	$166.83	$196.27	$296.42