Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.91 / $139.38 / $139.38	Facility	26	$53.91	$139.38	$139.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.20 / $153.15 / $425.75	Professional		$125.20	$153.15	$425.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $34.56 / $96.07	Professional	26	$28.11	$34.56	$96.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.08 / $117.24 / $327.95	Professional	TC	$97.08	$117.24	$327.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $27.75 / $81.70	Professional	26	$27.75	$27.75	$81.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.68 / $208.01 / $291.64	Professional		$141.68	$208.01	$291.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $50.81 / $71.23	Professional	26	$34.61	$50.81	$71.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.07 / $157.19 / $220.39	Professional	TC	$107.07	$157.19	$220.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.65 / $270.36 / $451.34	Professional		$173.65	$270.36	$451.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $67.26 / $106.72	Professional	26	$42.89	$67.26	$106.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.88 / $206.69 / $345.89	Professional	TC	$132.88	$206.69	$345.89
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $162.19 / $271.77 / $506.07	Professional		$162.19	$271.77	$506.07
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.61 / $65.41 / $122.29	Professional	26	$39.61	$65.41	$122.29
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $122.57 / $212.02 / $378.31	Professional	TC	$122.57	$212.02	$378.31
United Facility/Professional Professional Modifier Low / Median / High Price $142.07 / $197.45 / $359.25	Professional		$142.07	$197.45	$359.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $48.66 / $94.76	Professional	26	$35.95	$48.66	$94.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.04 / $162.25 / $308.18	Professional	TC	$110.04	$162.25	$308.18
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $125.64 / $146.75 / $221.63	Professional		$125.64	$146.75	$221.63
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $29.29 / $34.50 / $47.49	Professional	26	$29.29	$34.50	$47.49
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $95.45 / $112.29 / $163.29	Professional	TC	$95.45	$112.29	$163.29