Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.37 / $67.37 / $68.31	Facility	26	$67.37	$67.37	$68.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $145.06 / $453.52	Professional		$69.90	$145.06	$453.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $16.71 / $51.87	Professional	26	$12.98	$16.71	$51.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.37 / $129.36 / $407.07	Professional	TC	$55.37	$129.36	$407.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.60 / $36.84 / $144.88	Professional	26	$35.60	$36.84	$144.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.83 / $136.30 / $195.44	Professional		$92.83	$136.30	$195.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $64.59 / $90.92	Professional	26	$43.99	$64.59	$90.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.84 / $71.70 / $103.97	Professional	TC	$48.84	$71.70	$103.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.80 / $200.52 / $425.65	Professional		$121.80	$200.52	$425.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.74 / $64.06 / $135.41	Professional	26	$32.74	$64.06	$135.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.59 / $117.49 / $382.52	Professional	TC	$65.59	$117.49	$382.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $100.97 / $167.00 / $328.03	Professional		$100.97	$167.00	$328.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $50.36 / $87.11 / $165.89	Professional	26	$50.36	$87.11	$165.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $55.94 / $99.38 / $184.21	Professional	TC	$55.94	$99.38	$184.21
United Facility/Professional Professional Modifier Low / Median / High Price $135.10 / $163.24 / $502.13	Professional		$135.10	$163.24	$502.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $60.22 / $90.70	Professional	26	$17.63	$60.22	$90.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.85 / $85.52 / $410.24	Professional	TC	$61.85	$85.52	$410.24
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $85.18 / $117.21 / $172.16	Professional		$85.18	$117.21	$172.16
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $37.11 / $55.67	Professional	26	$16.45	$37.11	$55.67
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $59.61 / $155.71	Professional	TC	$48.07	$59.61	$155.71