Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.81 / $214.75 / $214.75	Facility	26	$52.81	$214.75	$214.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.77 / $286.18 / $854.62	Professional		$178.77	$286.18	$854.62
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 $135.80 / $224.62 / $706.78	Professional	TC	$135.80	$224.62	$706.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.24 / $199.24 / $199.24	Professional		$199.24	$199.24	$199.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.13 / $67.87 / $174.30	Professional	26	$42.13	$67.87	$174.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.00 / $350.39 / $508.06	Professional		$164.00	$350.39	$508.06
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 $111.27 / $237.74 / $340.89	Professional	TC	$111.27	$237.74	$340.89
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 $225.67 / $393.48 / $714.62	Professional		$225.67	$393.48	$714.62
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 $155.41 / $276.20 / $521.89	Professional	TC	$155.41	$276.20	$521.89
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $187.74 / $333.65 / $618.42	Professional		$187.74	$333.65	$618.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $107.04 / $198.83	Professional	26	$60.36	$107.04	$198.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $127.38 / $226.38 / $419.60	Professional	TC	$127.38	$226.38	$419.60
United Facility/Professional Professional Modifier Low / Median / High Price $243.68 / $287.86 / $527.07	Professional		$243.68	$287.86	$527.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.05 / $88.79 / $345.44	Professional	26	$62.05	$88.79	$345.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.91 / $196.41 / $390.19	Professional	TC	$171.91	$196.41	$390.19
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $154.84 / $213.06 / $302.81	Professional		$154.84	$213.06	$302.81
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 $110.38 / $136.87 / $236.39	Professional	TC	$110.38	$136.87	$236.39