Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $52.48	Facility	26	$25.12	$25.12	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $281.84	Professional		$61.66	$120.23	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $40.74 / $75.86	Professional	26	$25.12	$40.74	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $85.11 / $190.55	Professional	TC	$23.99	$85.11	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $107.15	Professional		$85.11	$85.11	$107.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $89.13	Professional	26	$23.44	$23.44	$89.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $229.09 / $338.84	Professional		$100.00	$229.09	$338.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $61.66 / $89.13	Professional	26	$26.92	$61.66	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $169.82 / $245.47	Professional	TC	$72.44	$169.82	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $208.93 / $371.54	Professional		$134.90	$208.93	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $56.23 / $109.65	Professional	26	$33.88	$56.23	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $154.88 / $263.03	Professional	TC	$97.72	$154.88	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $181.97 / $263.03	Professional		$114.82	$181.97	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $47.86 / $70.79	Professional	26	$30.90	$47.86	$70.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $131.83 / $194.98	Professional	TC	$85.11	$131.83	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $275.42	Professional		$102.33	$144.54	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $38.02 / $70.79	Professional	26	$27.54	$38.02	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $104.71 / $199.53	Professional	TC	$74.13	$104.71	$199.53
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $20.42 / $20.42	Facility	26	$17.38	$20.42	$20.42