Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.79 / $76.79 / $123.04	Facility	26	$76.79	$76.79	$123.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.38 / $275.89 / $572.67	Professional		$224.38	$275.89	$572.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.27 / $76.79 / $195.49	Professional	26	$64.27	$76.79	$195.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $160.11 / $199.10 / $377.18	Professional	TC	$160.11	$199.10	$377.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $101.60 / $186.42	Professional	26	$63.02	$101.60	$186.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.48 / $479.62 / $681.63	Professional		$224.48	$479.62	$681.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.93 / $168.63 / $238.47	Professional	26	$78.93	$168.63	$238.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.56 / $311.00 / $439.81	Professional	TC	$145.56	$311.00	$439.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.83 / $502.15 / $712.75	Professional		$306.83	$502.15	$712.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.70 / $165.97 / $242.99	Professional	26	$99.70	$165.97	$242.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.01 / $347.62 / $469.75	Professional	TC	$203.01	$347.62	$469.75
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $256.99 / $456.72 / $846.55	Professional		$256.99	$456.72	$846.55
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $90.35 / $160.57 / $297.62	Professional	26	$90.35	$160.57	$297.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $166.64 / $296.14 / $548.92	Professional	TC	$166.64	$296.14	$548.92
United Facility/Professional Professional Modifier Low / Median / High Price $303.02 / $351.71 / $780.62	Professional		$303.02	$351.71	$780.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.08 / $118.75 / $218.57	Professional	26	$85.08	$118.75	$218.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.32 / $241.76 / $546.27	Professional	TC	$184.32	$241.76	$546.27
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $129.02 / $228.19 / $375.83	Professional		$129.02	$228.19	$375.83
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $66.16 / $79.31 / $107.29	Professional	26	$66.16	$79.31	$107.29
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $52.67 / $151.55 / $232.46	Professional	TC	$52.67	$151.55	$232.46