Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.45 / $179.69 / $179.69	Facility	26	$67.45	$179.69	$179.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.38 / $145.97 / $450.97	Professional		$84.38	$145.97	$450.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.20 / $44.37 / $124.23	Professional	26	$36.20	$44.37	$124.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.18 / $103.82 / $324.17	Professional	TC	$48.18	$103.82	$324.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $143.07 / $143.07	Professional	26	$34.79	$143.07	$143.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.74 / $275.06 / $388.98	Professional		$128.74	$275.06	$388.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.34 / $92.61 / $130.96	Professional	26	$43.34	$92.61	$130.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.39 / $182.45 / $258.02	Professional	TC	$85.39	$182.45	$258.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.30 / $58.30 / $58.30	Facility	26	$58.30	$58.30	$58.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.03 / $299.32 / $490.36	Professional		$172.03	$299.32	$490.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.26 / $91.28 / $133.72	Professional	26	$55.26	$91.28	$133.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.73 / $207.40 / $372.61	Professional	TC	$114.73	$207.40	$372.61
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $147.44 / $261.92 / $485.48	Professional		$147.44	$261.92	$485.48
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $49.62 / $88.18 / $163.44	Professional	26	$49.62	$88.18	$163.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $97.76 / $173.74 / $322.02	Professional	TC	$97.76	$173.74	$322.02
United Facility/Professional Professional Modifier Low / Median / High Price $181.73 / $202.94 / $399.91	Professional		$181.73	$202.94	$399.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $63.78 / $111.32	Professional	26	$47.33	$63.78	$111.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.81 / $144.10 / $268.68	Professional	TC	$121.81	$144.10	$268.68
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $153.82 / $215.80	Professional		$113.94	$153.82	$215.80
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $44.13 / $59.70	Professional	26	$36.81	$44.13	$59.70
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $76.30 / $92.23 / $151.68	Professional	TC	$76.30	$92.23	$151.68