Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.81 / $213.37 / $213.37	Facility	26	$52.81	$213.37	$213.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.15 / $272.22 / $846.78	Professional		$176.15	$272.22	$846.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.97 / $52.81 / $147.84	Professional	26	$42.97	$52.81	$147.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.18 / $222.12 / $698.94	Professional	TC	$133.18	$222.12	$698.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $67.87 / $174.30	Professional	26	$40.72	$67.87	$174.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.67 / $420.19 / $594.23	Professional		$196.67	$420.19	$594.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.72 / $112.65 / $159.30	Professional	26	$52.72	$112.65	$159.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.94 / $307.54 / $434.92	Professional	TC	$143.94	$307.54	$434.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.83 / $68.83 / $68.83	Facility	26	$68.83	$68.83	$68.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.02 / $464.72 / $716.76	Professional		$264.02	$464.72	$716.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.17 / $111.07 / $162.96	Professional	26	$67.17	$111.07	$162.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.17 / $352.48 / $576.29	Professional	TC	$195.17	$352.48	$576.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $234.62 / $449.58 / $741.63	Professional		$234.62	$449.58	$741.63
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $107.27 / $198.83	Professional	26	$60.36	$107.27	$198.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $164.78 / $292.85 / $542.79	Professional	TC	$164.78	$292.85	$542.79
United Facility/Professional Professional Modifier Low / Median / High Price $280.23 / $317.57 / $1,348.76	Professional		$280.23	$317.57	$1,348.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.81 / $77.75 / $132.02	Professional	26	$56.81	$77.75	$132.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.46 / $250.09 / $455.62	Professional	TC	$208.46	$250.09	$455.62
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $178.32 / $239.38 / $337.74	Professional		$178.32	$239.38	$337.74
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $52.91 / $71.58	Professional	26	$44.14	$52.91	$71.58
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $133.86 / $160.63 / $253.53	Professional	TC	$133.86	$160.63	$253.53