Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.25 / $64.23 / $178.27	Facility	26	$48.25	$64.23	$178.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.61 / $146.68 / $402.26	Professional		$112.61	$146.68	$402.26
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 $74.95 / $98.44 / $276.80	Professional	TC	$74.95	$98.44	$276.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.14 / $153.07 / $315.70	Professional		$100.14	$153.07	$315.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $52.78 / $150.86	Professional	26	$36.72	$52.78	$150.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $104.65 / $104.65	Professional	TC	$104.65	$104.65	$104.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.03 / $190.91 / $267.67	Professional		$130.03	$190.91	$267.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.61 / $66.95 / $93.88	Professional	26	$45.61	$66.95	$93.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.42 / $123.95 / $173.79	Professional	TC	$84.42	$123.95	$173.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.82 / $260.11 / $420.20	Professional		$167.82	$260.11	$420.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.97 / $88.11 / $140.13	Professional	26	$56.97	$88.11	$140.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.19 / $168.60 / $277.57	Professional	TC	$110.19	$168.60	$277.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $148.86 / $257.50 / $490.36	Professional		$148.86	$257.50	$490.36
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $91.70 / $161.15	Professional	26	$52.21	$91.70	$161.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $96.65 / $167.19 / $298.31	Professional	TC	$96.65	$167.19	$298.31
United Facility/Professional Professional Modifier Low / Median / High Price $146.91 / $182.46 / $325.04	Professional		$146.91	$182.46	$325.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.40 / $63.86 / $123.47	Professional	26	$48.40	$63.86	$123.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.12 / $118.60 / $202.52	Professional	TC	$99.12	$118.60	$202.52
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $134.13 / $197.18	Professional		$111.78	$134.13	$197.18
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 $73.56 / $87.55 / $125.82	Professional	TC	$73.56	$87.55	$125.82