Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $76.39 / $200.16	Facility	26	$46.25	$76.39	$200.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $222.37 / $688.49	Professional		$134.66	$222.37	$688.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $46.25 / $129.60	Professional	26	$37.00	$46.25	$129.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.67 / $184.55 / $558.89	Professional	TC	$97.67	$184.55	$558.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $368.85 / $368.85	Professional		$129.75	$368.85	$368.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $58.30 / $149.75	Professional	26	$34.97	$58.30	$149.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.31 / $93.31 / $93.31	Professional	TC	$93.31	$93.31	$93.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.71 / $337.95 / $477.92	Professional		$151.71	$337.95	$477.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $96.75 / $136.82	Professional	26	$45.29	$96.75	$136.82
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $227.56 / $506.92 / $716.89	Professional	50	$227.56	$506.92	$716.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $241.19 / $341.09	Professional	TC	$106.42	$241.19	$341.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.41 / $64.41 / $64.41	Facility	26	$64.41	$64.41	$64.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.83 / $378.08 / $597.13	Professional		$212.83	$378.08	$597.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.02 / $95.85 / $139.97	Professional	26	$58.02	$95.85	$139.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.52 / $275.97 / $465.44	Professional	TC	$153.52	$275.97	$465.44
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $181.08 / $321.82 / $596.50	Professional		$181.08	$321.82	$596.50
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $89.67 / $170.77	Professional	26	$51.84	$89.67	$170.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $129.22 / $229.67 / $425.70	Professional	TC	$129.22	$229.67	$425.70
United Facility/Professional Professional Modifier Low / Median / High Price $225.01 / $252.32 / $494.62	Professional		$225.01	$252.32	$494.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.97 / $66.63 / $135.66	Professional	26	$49.97	$66.63	$135.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.87 / $186.09 / $354.69	Professional	TC	$162.87	$186.09	$354.69
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $128.57 / $176.91 / $243.51	Professional		$128.57	$176.91	$243.51
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $47.72 / $63.05	Professional	26	$38.47	$47.72	$63.05
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.09 / $108.11 / $189.46	Professional	TC	$90.09	$108.11	$189.46