Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.64 / $225.31 / $225.31	Facility	26	$55.64	$225.31	$225.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.74 / $293.87 / $877.25	Professional		$180.74	$293.87	$877.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.23 / $55.64 / $155.79	Professional	26	$45.23	$55.64	$155.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.51 / $238.22 / $721.49	Professional	TC	$135.51	$238.22	$721.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $130.62 / $182.88	Professional	26	$44.17	$130.62	$182.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.58 / $355.92 / $516.08	Professional		$166.58	$355.92	$516.08
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 $111.27 / $237.74 / $340.89	Professional	TC	$111.27	$237.74	$340.89
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 $229.00 / $405.82 / $724.19	Professional		$229.00	$405.82	$724.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.87 / $116.51 / $170.98	Professional	26	$70.87	$116.51	$170.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.41 / $275.42 / $595.98	Professional	TC	$155.41	$275.42	$595.98
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $190.70 / $338.19 / $628.17	Professional		$190.70	$338.19	$628.17
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.32 / $104.38 / $208.58	Professional	26	$63.32	$104.38	$208.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $127.38 / $220.34 / $419.60	Professional	TC	$127.38	$220.34	$419.60
United Facility/Professional Professional Modifier Low / Median / High Price $246.25 / $303.77 / $624.62	Professional		$246.25	$303.77	$624.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.81 / $81.18 / $164.16	Professional	26	$55.81	$81.18	$164.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.55 / $206.08 / $463.51	Professional	TC	$170.55	$206.08	$463.51
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $215.19 / $305.95	Professional		$156.38	$215.19	$305.95
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 $109.51 / $135.79 / $244.09	Professional	TC	$109.51	$135.79	$244.09