Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $104.71 / $213.80	Facility	26	$52.48	$104.71	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $489.78	Professional		$112.20	$194.98	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $181.97	Professional	26	$52.48	$85.11	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $173.78 / $295.12	Professional	TC	$114.82	$173.78	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $42.66 / $173.78	Professional	26	$40.74	$42.66	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $389.05 / $588.84	Professional		$165.96	$389.05	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $123.03 / $177.83	Professional	26	$53.70	$123.03	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $263.03 / $416.87	Professional	TC	$112.20	$263.03	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $741.31	Professional		$229.09	$416.87	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $112.20 / $169.82	Professional	26	$69.18	$112.20	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $295.12 / $602.56	Professional	TC	$158.49	$295.12	$602.56
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $457.09	Professional		$190.55	$302.00	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $141.25	Professional	26	$61.66	$95.50	$141.25
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $309.03	Professional	TC	$131.83	$204.17	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $588.84	Professional		$194.98	$295.12	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $144.54	Professional	26	$53.70	$77.62	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $389.05	Professional	TC	$134.90	$208.93	$389.05
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $40.74 / $40.74	Facility	26	$34.67	$40.74	$40.74