Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $41.69 / $85.11	Facility	26	$22.39	$41.69	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $234.42	Professional		$72.44	$97.72	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $72.44	Professional	26	$20.89	$33.88	$72.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $69.18 / $141.25	Professional	TC	$53.70	$69.18	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $31.62 / $77.62	Professional	26	$22.39	$31.62	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $151.36 / $199.53	Professional		$93.33	$151.36	$199.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $43.65 / $58.88	Professional	26	$27.54	$43.65	$58.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $104.71 / $141.25	Professional	TC	$66.07	$104.71	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $295.12	Professional		$109.65	$154.88	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $45.71 / $85.11	Professional	26	$31.62	$45.71	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $120.23 / $213.80	Professional	TC	$77.62	$120.23	$213.80
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $251.19	Professional		$107.15	$169.82	$251.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $72.44	Professional	26	$32.36	$50.12	$72.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $120.23 / $177.83	Professional	TC	$77.62	$120.23	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $245.47	Professional		$85.11	$128.82	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.90 / $69.18	Professional	26	$22.91	$38.90	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $91.20 / $173.78	Professional	TC	$63.10	$91.20	$173.78
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $21.38 / $21.38	Facility	26	$18.20	$21.38	$21.38