Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.72 / $225.31 / $225.31	Facility	26	$85.72	$225.31	$225.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.40 / $350.87 / $1,093.73	Professional		$217.40	$350.87	$1,093.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.63 / $55.64 / $155.79	Professional	26	$44.63	$55.64	$155.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.76 / $298.10 / $937.94	Professional	TC	$172.76	$298.10	$937.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $44.24 / $46.00	Professional	26	$43.93	$44.24	$46.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.14 / $410.51 / $595.23	Professional		$192.14	$410.51	$595.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.99 / $117.49 / $166.15	Professional	26	$54.99	$117.49	$166.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.15 / $293.02 / $420.17	Professional	TC	$137.15	$293.02	$420.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.14 / $72.14 / $72.14	Facility	26	$72.14	$72.14	$72.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.37 / $458.03 / $838.11	Professional		$265.37	$458.03	$838.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.41 / $115.81 / $169.96	Professional	26	$70.41	$115.81	$169.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.60 / $331.77 / $670.39	Professional	TC	$191.60	$331.77	$670.39
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $219.96 / $390.91 / $724.57	Professional		$219.96	$390.91	$724.57
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $108.89 / $207.36	Professional	26	$62.95	$108.89	$207.36
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $157.01 / $279.04 / $517.21	Professional	TC	$157.01	$279.04	$517.21
United Facility/Professional Professional Modifier Low / Median / High Price $293.64 / $345.97 / $748.51	Professional		$293.64	$345.97	$748.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.20 / $80.17 / $161.56	Professional	26	$57.20	$80.17	$161.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.39 / $249.54 / $586.95	Professional	TC	$218.39	$249.54	$586.95
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $186.82 / $205.50 / $261.55	Professional		$186.82	$205.50	$261.55
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $46.26 / $51.25 / $55.91	Professional	26	$46.26	$51.25	$55.91
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $139.22 / $154.26 / $168.29	Professional	TC	$139.22	$154.26	$168.29