Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.25 / $64.80 / $179.65	Facility	26	$48.25	$64.80	$179.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $132.06 / $304.20	Professional		$97.48	$132.06	$304.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $48.25 / $125.46	Professional	26	$37.65	$48.25	$125.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.83 / $83.81 / $235.66	Professional	TC	$59.83	$83.81	$235.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $92.34 / $273.77	Professional		$87.11	$92.34	$273.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $52.39 / $149.78	Professional	26	$34.95	$52.39	$149.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.89 / $165.74 / $232.38	Professional		$112.89	$165.74	$232.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $66.48 / $93.22	Professional	26	$45.29	$66.48	$93.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.59 / $99.25 / $139.15	Professional	TC	$67.59	$99.25	$139.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.47 / $226.68 / $364.14	Professional		$146.47	$226.68	$364.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $88.11 / $139.11	Professional	26	$56.52	$88.11	$139.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.65 / $136.63 / $222.55	Professional	TC	$88.65	$136.63	$222.55
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $223.54 / $425.70	Professional		$129.22	$223.54	$425.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $89.67 / $160.00	Professional	26	$51.84	$89.67	$160.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $77.39 / $137.24 / $254.93	Professional	TC	$77.39	$137.24	$254.93
United Facility/Professional Professional Modifier Low / Median / High Price $124.51 / $159.11 / $281.26	Professional		$124.51	$159.11	$281.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.41 / $63.04 / $111.69	Professional	26	$48.41	$63.04	$111.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.98 / $99.69 / $169.57	Professional	TC	$80.98	$99.69	$169.57
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $116.75 / $171.62	Professional		$97.29	$116.75	$171.62
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $37.94 / $45.47 / $61.51	Professional	26	$37.94	$45.47	$61.51
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $59.08 / $70.31 / $100.03	Professional	TC	$59.08	$70.31	$100.03