Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $147.91 / $147.91	Facility	26	$60.26	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $275.42	Professional		$72.44	$95.50	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.67 / $120.23	Professional	26	$34.67	$44.67	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $47.86 / $186.21	Professional	TC	$32.36	$47.86	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $61.66	Professional		$52.48	$52.48	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $46.77 / $120.23	Professional	26	$28.84	$46.77	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $177.83	Professional		$79.43	$125.89	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $58.88 / $83.18	Professional	26	$37.15	$58.88	$83.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $66.07 / $91.20	Professional	TC	$41.69	$66.07	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $154.88 / $275.42	Professional		$93.33	$154.88	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $75.86 / $109.65	Professional	26	$44.67	$75.86	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $79.43 / $138.04	Professional	TC	$44.67	$79.43	$138.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $134.90 / $208.93	Professional		$79.43	$134.90	$208.93
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $66.07 / $97.72	Professional	26	$42.66	$66.07	$97.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $77.62 / $112.20	Professional	TC	$48.98	$77.62	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $208.93	Professional		$87.10	$120.23	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $97.72	Professional	26	$38.02	$52.48	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $56.23 / $128.82	Professional	TC	$40.74	$56.23	$128.82
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $28.18 / $28.18	Facility	26	$23.99	$28.18	$28.18