Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.35 / $35.35 / $49.86	Facility	26	$35.35	$35.35	$49.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $107.06 / $124.83	Professional		$89.17	$107.06	$124.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $31.21 / $43.24	Professional	26	$26.96	$31.21	$43.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.21 / $74.53 / $81.59	Professional	TC	$62.21	$74.53	$81.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.47 / $26.77 / $105.76	Professional	26	$24.47	$26.77	$105.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $153.87 / $220.63	Professional		$104.80	$153.87	$220.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.02 / $47.02 / $66.48	Professional	26	$32.02	$47.02	$66.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.78 / $106.85 / $151.10	Professional	TC	$72.78	$106.85	$151.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.79 / $221.19 / $335.43	Professional		$135.79	$221.19	$335.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.70 / $66.59 / $97.91	Professional	26	$41.70	$66.59	$97.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.15 / $154.93 / $237.52	Professional	TC	$96.15	$154.93	$237.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $119.98 / $210.72 / $395.23	Professional		$119.98	$210.72	$395.23
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $63.41 / $120.76	Professional	26	$36.65	$63.41	$120.76
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $83.32 / $148.08 / $274.45	Professional	TC	$83.32	$148.08	$274.45
United Facility/Professional Professional Modifier Low / Median / High Price $114.91 / $146.50 / $265.76	Professional		$114.91	$146.50	$265.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.06 / $46.20 / $88.36	Professional	26	$36.06	$46.20	$88.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.83 / $120.23 / $272.89	Professional	TC	$86.83	$120.23	$272.89
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $86.79 / $104.15 / $153.10	Professional		$86.79	$104.15	$153.10
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $26.65 / $31.35 / $47.35	Professional	26	$26.65	$31.35	$47.35
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $59.52 / $70.02 / $105.75	Professional	TC	$59.52	$70.02	$105.75