Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.06 / $108.04 / $218.67	Facility	26	$54.06	$108.04	$218.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.95 / $233.43 / $694.52	Professional		$116.95	$233.43	$694.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $54.06 / $151.31	Professional	26	$44.02	$54.06	$151.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.92 / $172.62 / $543.21	Professional	TC	$72.92	$172.62	$543.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $43.46 / $69.54	Professional	26	$41.47	$43.46	$69.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.24 / $286.81 / $411.25	Professional		$134.24	$286.81	$411.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.02 / $115.41 / $163.21	Professional	26	$54.02	$115.41	$163.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $171.39 / $242.37	Professional	TC	$80.22	$171.39	$242.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.33 / $70.33 / $70.33	Facility	26	$70.33	$70.33	$70.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.40 / $319.08 / $583.88	Professional		$178.40	$319.08	$583.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.86 / $113.79 / $166.97	Professional	26	$68.86	$113.79	$166.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.77 / $194.56 / $434.02	Professional	TC	$107.77	$194.56	$434.02
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $153.66 / $269.89 / $506.20	Professional		$153.66	$269.89	$506.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $61.84 / $106.97 / $203.71	Professional	26	$61.84	$106.97	$203.71
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $91.83 / $162.85 / $302.50	Professional	TC	$91.83	$162.85	$302.50
United Facility/Professional Professional Modifier Low / Median / High Price $187.19 / $250.00 / $438.61	Professional		$187.19	$250.00	$438.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.35 / $79.29 / $159.56	Professional	26	$54.35	$79.29	$159.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $113.24 / $135.88 / $253.33	Professional	TC	$113.24	$135.88	$253.33
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $118.49 / $163.04 / $239.05	Professional		$118.49	$163.04	$239.05
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $45.46 / $54.49 / $73.72	Professional	26	$45.46	$54.49	$73.72
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $72.70 / $87.24 / $185.05	Professional	TC	$72.70	$87.24	$185.05