Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.95 / $97.48 / $127.52	Facility	26	$33.95	$97.48	$127.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.02 / $122.64 / $337.65	Professional		$101.02	$122.64	$337.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.06 / $33.95 / $88.29	Professional	26	$26.06	$33.95	$88.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.95 / $88.68 / $249.36	Professional	TC	$74.95	$88.68	$249.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.59 / $52.45 / $78.20	Professional	26	$32.59	$52.45	$78.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.30 / $194.23 / $274.68	Professional		$132.30	$194.23	$274.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $59.84 / $84.47	Professional	26	$40.76	$59.84	$84.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.54 / $134.40 / $190.06	Professional	TC	$91.54	$134.40	$190.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.11 / $249.07 / $425.15	Professional		$172.11	$249.07	$425.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.21 / $68.11 / $125.91	Professional	26	$48.21	$68.11	$125.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.14 / $181.41 / $299.24	Professional	TC	$121.14	$181.41	$299.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $268.58 / $498.89	Professional		$151.44	$268.58	$498.89
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $46.66 / $80.70 / $153.69	Professional	26	$46.66	$80.70	$153.69
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $104.79 / $184.04 / $345.19	Professional	TC	$104.79	$184.04	$345.19
United Facility/Professional Professional Modifier Low / Median / High Price $121.53 / $188.72 / $464.24	Professional		$121.53	$188.72	$464.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $59.65 / $103.35	Professional	26	$33.32	$59.65	$103.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.21 / $122.34 / $255.37	Professional	TC	$88.21	$122.34	$255.37
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $110.56 / $129.13 / $195.03	Professional		$110.56	$129.13	$195.03
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $39.20 / $51.99	Professional	26	$31.19	$39.20	$51.99
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $75.34 / $88.64 / $125.82	Professional	TC	$75.34	$88.64	$125.82