Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.11 / $37.11 / $66.09	Facility	26	$37.11	$37.11	$66.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.58 / $104.98 / $157.05	Professional		$85.58	$104.98	$157.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.21 / $37.11 / $72.80	Professional	26	$27.21	$37.11	$72.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.70 / $141.08 / $208.00	Professional	50	$46.70	$141.08	$208.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.37 / $70.84 / $128.71	Professional	TC	$58.37	$70.84	$128.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $76.25 / $80.59	Professional		$76.25	$76.25	$80.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.44 / $38.88 / $79.38	Professional	26	$25.44	$38.88	$79.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $114.37 / $114.37 / $120.89	Professional	50	$114.37	$114.37	$120.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.98 / $145.32 / $203.75	Professional		$98.98	$145.32	$203.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.64 / $49.39 / $69.23	Professional	26	$33.64	$49.39	$69.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $148.47 / $217.98 / $305.62	Professional	50	$148.47	$217.98	$305.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.34 / $95.93 / $134.50	Professional	TC	$65.34	$95.93	$134.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.09 / $198.72 / $320.33	Professional		$128.09	$198.72	$320.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.90 / $63.68 / $102.95	Professional	26	$41.90	$63.68	$102.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.32 / $131.66 / $215.27	Professional	TC	$85.32	$131.66	$215.27
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $199.01 / $373.25	Professional		$113.31	$199.01	$373.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $38.51 / $66.61 / $118.86	Professional	26	$38.51	$66.61	$118.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $74.80 / $129.38 / $230.87	Professional	TC	$74.80	$129.38	$230.87
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $139.58 / $244.30	Professional		$114.82	$139.58	$244.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.03 / $46.65 / $91.24	Professional	26	$38.03	$46.65	$91.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.54 / $92.93 / $163.09	Professional	TC	$78.54	$92.93	$163.09
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $85.56 / $99.93 / $150.93	Professional		$85.56	$99.93	$150.93
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $27.73 / $32.61 / $46.63	Professional	26	$27.73	$32.61	$46.63
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $57.21 / $67.31 / $97.10	Professional	TC	$57.21	$67.31	$97.10