Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $69.18 / $177.83	Facility	26	$47.86	$69.18	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $467.74	Professional		$112.20	$204.17	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $89.13 / $151.36	Professional	26	$41.69	$89.13	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $104.71 / $302.00	Professional	TC	$74.13	$104.71	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $331.13	Professional		$107.15	$151.36	$331.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $154.88	Professional	26	$54.95	$69.18	$154.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $177.83	Professional	TC	$173.78	$173.78	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $275.42	Professional		$134.90	$199.53	$275.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $97.72	Professional	26	$46.77	$69.18	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $131.83 / $177.83	Professional	TC	$89.13	$131.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $245.47 / $407.38	Professional		$154.88	$245.47	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $138.04	Professional	26	$54.95	$85.11	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $165.96 / $263.03	Professional	TC	$104.71	$165.96	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $363.08	Professional		$154.88	$229.09	$363.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $123.03	Professional	26	$54.95	$83.18	$123.03
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $162.18 / $234.42	Professional	TC	$104.71	$162.18	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $371.54	Professional		$147.91	$190.55	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $125.89	Professional	26	$50.12	$66.07	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $123.03 / $245.47	Professional	TC	$97.72	$123.03	$245.47