Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.95 / $62.92 / $127.52	Facility	26	$33.95	$62.92	$127.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.51 / $113.58 / $312.19	Professional		$89.51	$113.58	$312.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.90 / $33.95 / $90.15	Professional	26	$25.90	$33.95	$90.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $79.63 / $219.50	Professional	TC	$63.61	$79.63	$219.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $89.98 / $89.98	Professional		$89.98	$89.98	$89.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.52 / $47.45 / $70.70	Professional	26	$29.52	$47.45	$70.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.09 / $171.91 / $243.11	Professional		$117.09	$171.91	$243.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.88 / $54.14 / $76.56	Professional	26	$36.88	$54.14	$76.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $117.78 / $166.56	Professional	TC	$80.22	$117.78	$166.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $221.05 / $375.21	Professional		$151.88	$221.05	$375.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.75 / $68.11 / $113.01	Professional	26	$45.75	$68.11	$113.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.15 / $153.97 / $262.20	Professional	TC	$106.15	$153.97	$262.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $134.05 / $235.43 / $441.57	Professional		$134.05	$235.43	$441.57
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $69.44 / $139.04	Professional	26	$42.21	$69.44	$139.04
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $91.83 / $161.28 / $302.50	Professional	TC	$91.83	$161.28	$302.50
United Facility/Professional Professional Modifier Low / Median / High Price $105.88 / $151.37 / $291.37	Professional		$105.88	$151.37	$291.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $52.08 / $93.50	Professional	26	$33.32	$52.08	$93.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.58 / $104.59 / $215.92	Professional	TC	$75.58	$104.59	$215.92
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $96.02 / $112.15 / $169.38	Professional		$96.02	$112.15	$169.38
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $29.43 / $35.81 / $46.71	Professional	26	$29.43	$35.81	$46.71
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $64.41 / $75.78 / $106.35	Professional	TC	$64.41	$75.78	$106.35