Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.87 / $49.59 / $99.10	Facility	26	$26.87	$49.59	$99.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.63 / $302.60	Professional		$79.43	$109.63	$302.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.48 / $24.03 / $69.88	Professional	26	$20.48	$24.03	$69.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.95 / $82.76 / $232.71	Professional	TC	$58.95	$82.76	$232.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	26	$30.20	$30.20	$30.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $184.26 / $260.58	Professional		$125.50	$184.26	$260.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $37.99 / $53.72	Professional	26	$25.88	$37.99	$53.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.63 / $146.27 / $206.48	Professional	TC	$99.63	$146.27	$206.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.55 / $227.89 / $404.00	Professional		$163.55	$227.89	$404.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $53.62 / $79.04	Professional	26	$32.36	$53.62	$79.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.26 / $173.83 / $324.95	Professional	TC	$129.26	$173.83	$324.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $143.68 / $255.35 / $473.30	Professional		$143.68	$255.35	$473.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $29.62 / $51.24 / $97.57	Professional	26	$29.62	$51.24	$97.57
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $114.05 / $202.26 / $375.69	Professional	TC	$114.05	$202.26	$375.69
United Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $164.55 / $437.75	Professional		$125.50	$164.55	$437.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.52 / $36.40 / $74.04	Professional	26	$26.52	$36.40	$74.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.91 / $122.44 / $248.05	Professional	TC	$86.91	$122.44	$248.05
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $88.58 / $113.00 / $170.67	Professional		$88.58	$113.00	$170.67
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $25.13 / $34.04	Professional	26	$21.00	$25.13	$34.04
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $68.04 / $88.30 / $121.71	Professional	TC	$68.04	$88.30	$121.71