Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.49 / $75.06 / $213.37	Facility	26	$46.49	$75.06	$213.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.32 / $231.03 / $689.27	Professional		$137.32	$231.03	$689.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $46.49 / $130.38	Professional	26	$39.65	$46.49	$130.38
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 $104.39 / $104.39 / $104.39	Professional		$104.39	$104.39	$104.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $58.30 / $149.75	Professional	26	$34.79	$58.30	$149.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.09 / $273.68 / $396.83	Professional		$128.09	$273.68	$396.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $96.75 / $136.82	Professional	26	$45.29	$96.75	$136.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.81 / $176.92 / $253.68	Professional	TC	$82.81	$176.92	$253.68
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 $175.76 / $310.68 / $607.34	Professional		$175.76	$310.68	$607.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.02 / $95.85 / $142.75	Professional	26	$58.02	$95.85	$142.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.69 / $204.47 / $479.22	Professional	TC	$115.69	$204.47	$479.22
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $146.63 / $260.61 / $483.05	Professional		$146.63	$260.61	$483.05
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $92.13 / $170.77	Professional	26	$51.84	$92.13	$170.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $94.84 / $168.48 / $312.27	Professional	TC	$94.84	$168.48	$312.27
United Facility/Professional Professional Modifier Low / Median / High Price $195.68 / $236.45 / $509.07	Professional		$195.68	$236.45	$509.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.89 / $66.63 / $143.57	Professional	26	$52.89	$66.63	$143.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.54 / $160.22 / $359.63	Professional	TC	$133.54	$160.22	$359.63
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $124.22 / $170.93 / $250.22	Professional		$124.22	$170.93	$250.22
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $47.72 / $66.87	Professional	26	$38.47	$47.72	$66.87
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $85.75 / $102.90 / $197.52	Professional	TC	$85.75	$102.90	$197.52