Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.68 / $225.31 / $225.31	Facility	26	$86.68	$225.31	$225.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.46 / $282.68 / $879.23	Professional		$181.46	$282.68	$879.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.08 / $55.64 / $155.79	Professional	26	$45.08	$55.64	$155.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.38 / $229.91 / $723.43	Professional	TC	$136.38	$229.91	$723.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.55 / $106.71 / $183.84	Professional	26	$44.55	$106.71	$183.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.55 / $357.99 / $519.08	Professional		$167.55	$357.99	$519.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.64 / $118.87 / $168.10	Professional	26	$55.64	$118.87	$168.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.92 / $239.12 / $342.87	Professional	TC	$111.92	$239.12	$342.87
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 $230.26 / $401.35 / $728.23	Professional		$230.26	$401.35	$728.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.09 / $117.12 / $171.88	Professional	26	$70.09	$117.12	$171.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.33 / $271.06 / $595.98	Professional	TC	$156.33	$271.06	$595.98
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $191.82 / $336.89 / $631.87	Professional		$191.82	$336.89	$631.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.69 / $104.99 / $209.80	Professional	26	$63.69	$104.99	$209.80
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $128.12 / $227.69 / $422.04	Professional	TC	$128.12	$227.69	$422.04
United Facility/Professional Professional Modifier Low / Median / High Price $247.61 / $299.91 / $626.78	Professional		$247.61	$299.91	$626.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.21 / $87.42 / $154.08	Professional	26	$60.21	$87.42	$154.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.91 / $207.72 / $466.46	Professional	TC	$171.91	$207.72	$466.46
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $157.26 / $216.39 / $306.94	Professional		$157.26	$216.39	$306.94
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 $110.38 / $136.87 / $244.46	Professional	TC	$110.38	$136.87	$244.46