Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $309.03	Professional		$107.15	$144.54	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $162.18	Professional	26	$46.77	$66.07	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $69.18 / $186.21	Professional	TC	$52.48	$69.18	$186.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $69.18 / $213.80	Professional	26	$53.70	$69.18	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $309.03	Professional		$125.89	$199.53	$309.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $104.71 / $138.04	Professional	26	$66.07	$104.71	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $147.91	Professional	TC	$58.88	$91.20	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $537.03	Professional		$162.18	$263.03	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $194.98	Professional	26	$75.86	$107.15	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $141.25 / $426.58	Professional	TC	$79.43	$141.25	$426.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $354.81	Professional		$144.54	$223.87	$354.81
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $120.23 / $173.78	Professional	26	$75.86	$120.23	$173.78
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $107.15 / $158.49	Professional	TC	$69.18	$107.15	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $239.88 / $575.44	Professional		$144.54	$239.88	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $158.49	Professional	26	$56.23	$89.13	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $109.65 / $295.12	Professional	TC	$70.79	$109.65	$295.12
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $48.98 / $48.98	Facility	26	$40.74	$48.98	$48.98