Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.12 / $28.12 / $40.17	Facility	26	$28.12	$28.12	$40.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.90 / $92.35 / $202.95	Professional		$75.90	$92.35	$202.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.97 / $25.78 / $48.06	Professional	26	$20.97	$25.78	$48.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.93 / $66.56 / $154.88	Professional	TC	$54.93	$66.56	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $79.23 / $79.23	Professional		$79.23	$79.23	$79.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $24.50 / $82.25	Professional	26	$19.98	$24.50	$82.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.51 / $151.97 / $213.07	Professional		$103.51	$151.97	$213.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.91 / $36.57 / $51.27	Professional	26	$24.91	$36.57	$51.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.59 / $115.40 / $161.80	Professional	TC	$78.59	$115.40	$161.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.74 / $194.32 / $331.39	Professional		$125.74	$194.32	$331.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.22 / $48.08 / $78.20	Professional	26	$31.22	$48.08	$78.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.48 / $140.36 / $252.73	Professional	TC	$90.48	$140.36	$252.73
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $118.50 / $210.15 / $390.35	Professional		$118.50	$210.15	$390.35
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $50.07 / $88.00	Professional	26	$28.51	$50.07	$88.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $89.98 / $159.91 / $296.39	Professional	TC	$89.98	$159.91	$296.39
United Facility/Professional Professional Modifier Low / Median / High Price $103.92 / $148.79 / $239.79	Professional		$103.92	$148.79	$239.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $36.97 / $56.88	Professional	26	$28.35	$36.97	$56.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.08 / $111.15 / $170.46	Professional	TC	$78.08	$111.15	$170.46
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $105.24 / $161.41	Professional		$90.67	$105.24	$161.41
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $25.13 / $35.89	Professional	26	$21.12	$25.13	$35.89
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $63.34 / $80.94 / $113.31	Professional	TC	$63.34	$80.94	$113.31