Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.25 / $25.25 / $52.11	Facility	26	$25.25	$25.25	$52.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.07 / $69.44 / $204.30	Professional		$45.07	$69.44	$204.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.34 / $25.25 / $65.33	Professional	26	$21.34	$25.25	$65.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.73 / $44.19 / $133.80	Professional	TC	$23.73	$44.19	$133.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $38.65 / $62.61	Professional	26	$21.32	$38.65	$62.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.98 / $211.48 / $299.07	Professional		$98.98	$211.48	$299.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.52 / $56.67 / $80.14	Professional	26	$26.52	$56.67	$80.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.45 / $154.81 / $218.93	Professional	TC	$72.45	$154.81	$218.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.93 / $209.06 / $313.20	Professional		$131.93	$209.06	$313.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $56.15 / $80.95	Professional	26	$32.78	$56.15	$80.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.01 / $153.61 / $232.24	Professional	TC	$94.01	$153.61	$232.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $196.00 / $373.25	Professional		$113.31	$196.00	$373.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $30.36 / $50.87 / $93.71	Professional	26	$30.36	$50.87	$93.71
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $82.95 / $147.41 / $273.25	Professional	TC	$82.95	$147.41	$273.25
United Facility/Professional Professional Modifier Low / Median / High Price $103.33 / $142.96 / $274.92	Professional		$103.33	$142.96	$274.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $53.19 / $172.63	Professional	26	$30.83	$53.19	$172.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.18 / $99.93 / $197.52	Professional	TC	$76.18	$99.93	$197.52
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $83.90 / $100.68 / $148.31	Professional		$83.90	$100.68	$148.31
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $26.02 / $35.76	Professional	26	$22.05	$26.02	$35.76
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $61.24 / $74.03 / $116.84	Professional	TC	$61.24	$74.03	$116.84