Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.27 / $99.17 / $201.50	Facility	26	$49.27	$99.17	$201.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $229.93 / $685.04	Professional		$114.54	$229.93	$685.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.45 / $49.27 / $137.88	Professional	26	$40.45	$49.27	$137.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.09 / $180.65 / $547.13	Professional	TC	$74.09	$180.65	$547.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.59 / $92.10 / $163.55	Professional	26	$39.59	$92.10	$163.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $279.89 / $401.34	Professional		$131.00	$279.89	$401.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.49 / $105.74 / $149.53	Professional	26	$49.49	$105.74	$149.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.51 / $174.16 / $246.29	Professional	TC	$81.51	$174.16	$246.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.56 / $64.56 / $64.56	Facility	26	$64.56	$64.56	$64.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.19 / $310.89 / $588.41	Professional		$174.19	$310.89	$588.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.36 / $104.26 / $153.08	Professional	26	$63.36	$104.26	$153.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.51 / $196.85 / $439.20	Professional	TC	$109.51	$196.85	$439.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $246.70 / $494.02	Professional		$149.97	$246.70	$494.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $56.66 / $93.21 / $186.64	Professional	26	$56.66	$93.21	$186.64
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $93.32 / $165.85 / $307.41	Professional	TC	$93.32	$165.85	$307.41
United Facility/Professional Professional Modifier Low / Median / High Price $182.44 / $221.42 / $401.46	Professional		$182.44	$221.42	$401.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.98 / $73.01 / $148.05	Professional	26	$49.98	$73.01	$148.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.23 / $138.05 / $261.49	Professional	TC	$101.23	$138.05	$261.49
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $115.60 / $159.07 / $236.08	Professional		$115.60	$159.07	$236.08
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $41.43 / $49.66 / $67.18	Professional	26	$41.43	$49.66	$67.18
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $73.86 / $88.63 / $186.52	Professional	TC	$73.86	$88.63	$186.52