Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.84 / $76.84 / $158.26	Facility	26	$76.84	$76.84	$158.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.72 / $202.22 / $459.39	Professional		$155.72	$202.22	$459.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.75 / $76.84 / $195.42	Professional	26	$64.75	$76.84	$195.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.97 / $125.35 / $263.95	Professional	TC	$90.97	$125.35	$263.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.04 / $147.84 / $437.89	Professional		$140.04	$147.84	$437.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.06 / $66.94 / $187.10	Professional	26	$61.06	$66.94	$187.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.82 / $386.32 / $546.33	Professional		$180.82	$386.32	$546.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.25 / $169.32 / $239.45	Professional	26	$79.25	$169.32	$239.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.57 / $217.01 / $306.89	Professional	TC	$101.57	$217.01	$306.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.99 / $390.96 / $579.29	Professional		$239.99	$390.96	$579.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.48 / $167.22 / $243.92	Professional	26	$101.48	$167.22	$243.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.41 / $226.91 / $351.50	Professional	TC	$136.41	$226.91	$351.50
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $203.42 / $340.52 / $681.88	Professional		$203.42	$340.52	$681.88
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $90.72 / $156.93 / $298.83	Professional	26	$90.72	$156.93	$298.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $118.03 / $206.64 / $383.00	Professional	TC	$118.03	$206.64	$383.00
United Facility/Professional Professional Modifier Low / Median / High Price $226.95 / $275.81 / $544.17	Professional		$226.95	$275.81	$544.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $90.29 / $117.08 / $234.96	Professional	26	$90.29	$117.08	$234.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.41 / $156.10 / $314.57	Professional	TC	$124.41	$156.10	$314.57
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $158.44 / $190.14 / $279.51	Professional		$158.44	$190.14	$279.51
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $66.43 / $79.62 / $111.58	Professional	26	$66.43	$79.62	$111.58
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $91.54 / $109.85 / $173.38	Professional	TC	$91.54	$109.85	$173.38