Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.74 / $243.76 / $243.76	Facility	26	$136.74	$243.76	$243.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.71 / $243.78 / $756.41	Professional		$145.71	$243.78	$756.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.72 / $64.62 / $167.96	Professional	26	$46.72	$64.62	$167.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.22 / $186.96 / $588.44	Professional	TC	$97.22	$186.96	$588.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.84 / $73.84 / $73.84	Professional	26	$73.84	$73.84	$73.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.53 / $231.28 / $335.35	Professional		$157.53	$231.28	$335.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.31 / $129.65 / $183.02	Professional	26	$88.31	$129.65	$183.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.22 / $101.63 / $147.36	Professional	TC	$69.22	$101.63	$147.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.62 / $362.11 / $672.94	Professional		$207.62	$362.11	$672.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.37 / $140.18 / $270.33	Professional	26	$103.37	$140.18	$270.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.93 / $165.81 / $505.45	Professional	TC	$92.93	$165.81	$505.45
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $180.34 / $320.50 / $594.05	Professional		$180.34	$320.50	$594.05
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $101.09 / $179.27 / $333.00	Professional	26	$101.09	$179.27	$333.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $132.78 / $261.02	Professional	TC	$79.23	$132.78	$261.02
United Facility/Professional Professional Modifier Low / Median / High Price $218.81 / $303.88 / $659.97	Professional		$218.81	$303.88	$659.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.59 / $137.94 / $229.66	Professional	26	$79.59	$137.94	$229.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.57 / $121.52 / $367.79	Professional	TC	$100.57	$121.52	$367.79
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $137.40 / $189.06 / $273.20	Professional		$137.40	$189.06	$273.20
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $60.04 / $80.14 / $109.28	Professional	26	$60.04	$80.14	$109.28
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $64.54 / $80.03 / $213.16	Professional	TC	$64.54	$80.03	$213.16