Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.26 / $46.38 / $116.85	Facility	26	$31.26	$46.38	$116.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.66 / $92.78 / $254.23	Professional		$66.66	$92.78	$254.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.59 / $31.27 / $77.98	Professional	26	$24.59	$31.27	$77.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.07 / $61.52 / $172.97	Professional	TC	$42.07	$61.52	$172.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $92.06 / $189.88	Professional		$60.42	$92.06	$189.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.81 / $34.40 / $70.97	Professional	26	$22.81	$34.40	$70.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.28 / $114.93 / $161.13	Professional		$78.28	$114.93	$161.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.76 / $43.69 / $61.25	Professional	26	$29.76	$43.69	$61.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.52 / $71.23 / $99.88	Professional	TC	$48.52	$71.23	$99.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $157.09 / $251.94	Professional		$100.09	$157.09	$251.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.10 / $57.34 / $92.59	Professional	26	$37.10	$57.34	$92.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.25 / $98.02 / $158.04	Professional	TC	$63.25	$98.02	$158.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $89.61 / $147.72 / $295.18	Professional		$89.61	$147.72	$295.18
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $56.73 / $105.16	Professional	26	$34.07	$56.73	$105.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $55.55 / $97.56 / $171.46	Professional	TC	$55.55	$97.56	$171.46
United Facility/Professional Professional Modifier Low / Median / High Price $93.38 / $109.37 / $165.51	Professional		$93.38	$109.37	$165.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.84 / $41.67 / $82.49	Professional	26	$32.84	$41.67	$82.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.95 / $69.54 / $105.83	Professional	TC	$59.95	$69.54	$105.83
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $66.91 / $80.29 / $118.03	Professional		$66.91	$80.29	$118.03
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $24.75 / $29.67 / $40.14	Professional	26	$24.75	$29.67	$40.14
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $41.98 / $49.95 / $70.83	Professional	TC	$41.98	$49.95	$70.83