Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.95 / $127.52 / $127.52	Facility	26	$33.95	$127.52	$127.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $122.98 / $338.63	Professional		$109.45	$122.98	$338.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $33.95 / $88.29	Professional	26	$25.75	$33.95	$88.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $93.30 / $250.33	Professional	TC	$79.54	$93.30	$250.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.43 / $46.16 / $155.10	Professional	26	$37.43	$46.16	$155.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.21 / $214.65 / $303.55	Professional		$146.21	$214.65	$303.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.90 / $68.86 / $97.20	Professional	26	$46.90	$68.86	$97.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.30 / $145.79 / $208.14	Professional	TC	$99.30	$145.79	$208.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.82 / $282.36 / $468.91	Professional		$189.82	$282.36	$468.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.40 / $75.18 / $144.97	Professional	26	$47.40	$75.18	$144.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.43 / $211.43 / $333.90	Professional	TC	$133.43	$211.43	$333.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $172.62 / $318.89 / $551.37	Professional		$172.62	$318.89	$551.37
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $53.69 / $88.51 / $176.86	Professional	26	$53.69	$88.51	$176.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $113.68 / $196.64 / $374.47	Professional	TC	$113.68	$196.64	$374.47
United Facility/Professional Professional Modifier Low / Median / High Price $124.77 / $200.60 / $388.74	Professional		$124.77	$200.60	$388.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.03 / $66.58 / $98.53	Professional	26	$46.03	$66.58	$98.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.58 / $140.28 / $262.92	Professional	TC	$103.58	$140.28	$262.92
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $119.97 / $143.62 / $216.90	Professional		$119.97	$143.62	$216.90
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $43.81 / $59.75	Professional	26	$31.36	$43.81	$59.75
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $83.14 / $98.94 / $136.52	Professional	TC	$83.14	$98.94	$136.52