Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.32 / $132.94 / $223.97	Facility	26	$55.32	$132.94	$223.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.32 / $293.87 / $877.25	Professional		$181.32	$293.87	$877.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.23 / $55.32 / $154.79	Professional	26	$45.23	$55.32	$154.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.09 / $238.55 / $722.46	Professional	TC	$136.09	$238.55	$722.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $106.12 / $182.88	Professional	26	$44.17	$106.12	$182.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.94 / $354.53 / $514.05	Professional		$165.94	$354.53	$514.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.31 / $118.18 / $167.13	Professional	26	$55.31	$118.18	$167.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.63 / $236.36 / $338.91	Professional	TC	$110.63	$236.36	$338.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.09 / $72.09 / $72.09	Facility	26	$72.09	$72.09	$72.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.08 / $398.30 / $722.79	Professional		$228.08	$398.30	$722.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.09 / $116.51 / $170.98	Professional	26	$70.09	$116.51	$170.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.52 / $268.77 / $595.98	Professional	TC	$154.52	$268.77	$595.98
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $197.96 / $337.60 / $625.75	Professional		$197.96	$337.60	$625.75
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.32 / $112.53 / $208.58	Professional	26	$63.32	$112.53	$208.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $126.64 / $225.06 / $417.16	Professional	TC	$126.64	$225.06	$417.16
United Facility/Professional Professional Modifier Low / Median / High Price $220.75 / $297.74 / $528.85	Professional		$220.75	$297.74	$528.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.19 / $80.69 / $165.08	Professional	26	$57.19	$80.69	$165.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.10 / $204.08 / $464.48	Professional	TC	$170.10	$204.08	$464.48
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $156.10 / $214.79 / $306.45	Professional		$156.10	$214.79	$306.45
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $46.55 / $55.79 / $75.47	Professional	26	$46.55	$55.79	$75.47
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $109.22 / $135.43 / $244.46	Professional	TC	$109.22	$135.43	$244.46