Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $109.65 / $223.87	Facility	26	$56.23	$109.65	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $537.03	Professional		$169.82	$269.15	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $181.97	Professional	26	$53.70	$83.18	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $181.97 / $436.52	Professional	TC	$114.82	$181.97	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $181.97	Professional	26	$44.67	$44.67	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $398.11 / $588.84	Professional		$169.82	$398.11	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $128.82 / $186.21	Professional	26	$56.23	$128.82	$186.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $263.03 / $416.87	Professional	TC	$112.20	$263.03	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $758.58	Professional		$229.09	$416.87	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $117.49 / $177.83	Professional	26	$72.44	$117.49	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $295.12 / $602.56	Professional	TC	$158.49	$295.12	$602.56
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $457.09	Professional		$194.98	$302.00	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $100.00 / $147.91	Professional	26	$64.57	$100.00	$147.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $309.03	Professional	TC	$131.83	$204.17	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $602.56	Professional		$199.53	$309.03	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $151.36	Professional	26	$57.54	$81.28	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $213.80 / $407.38	Professional	TC	$134.90	$213.80	$407.38
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $42.66 / $42.66	Facility	26	$36.31	$42.66	$42.66