Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.82 / $115.71 / $235.19	Facility	26	$57.82	$115.71	$235.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.44 / $316.44 / $945.11	Professional		$182.44	$316.44	$945.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $57.83 / $161.90	Professional	26	$47.22	$57.83	$161.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.22 / $258.61 / $783.18	Professional	TC	$135.22	$258.61	$783.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $216.81 / $552.77 / $552.77	Professional		$216.81	$552.77	$552.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.37 / $74.51 / $191.37	Professional	26	$44.37	$74.51	$191.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.07 / $485.15 / $686.09	Professional		$227.07	$485.15	$686.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.90 / $123.71 / $174.95	Professional	26	$57.90	$123.71	$174.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.17 / $361.45 / $511.16	Professional	TC	$169.17	$361.45	$511.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.95 / $542.55 / $801.10	Professional		$302.95	$542.55	$801.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.42 / $121.88 / $178.91	Professional	26	$73.42	$121.88	$178.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.29 / $419.37 / $647.48	Professional	TC	$227.29	$419.37	$647.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $259.95 / $466.96 / $856.30	Professional		$259.95	$466.96	$856.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $117.79 / $218.33	Professional	26	$66.28	$117.79	$218.33
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $193.67 / $344.19 / $637.97	Professional	TC	$193.67	$344.19	$637.97
United Facility/Professional Professional Modifier Low / Median / High Price $311.58 / $351.65 / $636.22	Professional		$311.58	$351.65	$636.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.32 / $85.83 / $171.00	Professional	26	$58.32	$85.83	$171.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.37 / $280.77 / $1,118.38	Professional	TC	$232.37	$280.77	$1,118.38
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $195.39 / $267.60 / $370.07	Professional		$195.39	$267.60	$370.07
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $48.71 / $58.40 / $79.00	Professional	26	$48.71	$58.40	$79.00
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.32 / $175.58 / $277.13	Professional	TC	$146.32	$175.58	$277.13