Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $107.15 / $218.78	Facility	26	$53.70	$107.15	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $416.87	Professional		$134.90	$213.80	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $79.43 / $173.78	Professional	26	$53.70	$79.43	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $123.03 / $295.12	Professional	TC	$79.43	$123.03	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Professional	26	$70.79	$70.79	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $316.23 / $457.09	Professional		$134.90	$316.23	$457.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $125.89 / $181.97	Professional	26	$54.95	$125.89	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $190.55 / $302.00	Professional	TC	$81.28	$190.55	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $338.84 / $602.56	Professional		$186.21	$338.84	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $114.82 / $169.82	Professional	26	$70.79	$114.82	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $204.17 / $457.09	Professional	TC	$112.20	$204.17	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $363.08	Professional		$151.36	$245.47	$363.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $100.00 / $144.54	Professional	26	$63.10	$100.00	$144.54
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $154.88 / $218.78	Professional	TC	$95.50	$154.88	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $426.58	Professional		$151.36	$251.19	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $147.91	Professional	26	$56.23	$79.43	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $141.25 / $251.19	Professional	TC	$93.33	$141.25	$251.19
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $41.69 / $41.69	Facility	26	$35.48	$41.69	$41.69