Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.14 / $78.14 / $78.14	Facility	26	$78.14	$78.14	$78.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.26 / $216.19 / $264.22	Professional		$186.26	$216.19	$264.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.76 / $49.21 / $68.94	Professional	26	$42.76	$49.21	$68.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.19 / $166.97 / $195.28	Professional	TC	$144.19	$166.97	$195.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $40.09 / $40.09	Professional	26	$40.09	$40.09	$40.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.34 / $419.50 / $593.25	Professional		$196.34	$419.50	$593.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.14 / $107.12 / $151.47	Professional	26	$50.14	$107.12	$151.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.21 / $312.38 / $441.76	Professional	TC	$146.21	$312.38	$441.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.95 / $443.82 / $647.16	Professional		$261.95	$443.82	$647.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.22 / $105.63 / $154.93	Professional	26	$64.22	$105.63	$154.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.42 / $332.57 / $478.12	Professional	TC	$196.42	$332.57	$478.12
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $224.77 / $399.46 / $740.41	Professional		$224.77	$399.46	$740.41
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $100.81 / $189.08	Professional	26	$57.40	$100.81	$189.08
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $167.38 / $297.47 / $551.37	Professional	TC	$167.38	$297.47	$551.37
United Facility/Professional Professional Modifier Low / Median / High Price $248.63 / $317.39 / $722.55	Professional		$248.63	$317.39	$722.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $74.84 / $489.95	Professional	26	$57.40	$74.84	$489.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.45 / $246.93 / $500.97	Professional	TC	$184.45	$246.93	$500.97
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $256.61 / $282.27 / $359.25	Professional		$256.61	$282.27	$359.25
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $42.56 / $47.16 / $51.44	Professional	26	$42.56	$47.16	$51.44
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $212.20 / $235.11 / $256.49	Professional	TC	$212.20	$235.11	$256.49