Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.50 / $54.75 / $151.81	Facility	26	$41.50	$54.75	$151.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.69 / $105.10 / $284.52	Professional		$90.69	$105.10	$284.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.32 / $41.50 / $107.89	Professional	26	$32.32	$41.50	$107.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $63.61 / $178.83	Professional	TC	$56.82	$63.61	$178.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $90.41 / $150.68	Professional		$80.78	$90.41	$150.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.29 / $48.73 / $128.57	Professional	26	$31.29	$48.73	$128.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $82.22 / $82.22 / $82.22	Professional	TC	$82.22	$82.22	$82.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.13 / $154.34 / $216.40	Professional		$105.13	$154.34	$216.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $56.99 / $79.90	Professional	26	$38.82	$56.99	$79.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.31 / $97.35 / $136.49	Professional	TC	$66.31	$97.35	$136.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.36 / $200.09 / $338.89	Professional		$129.36	$200.09	$338.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.70 / $75.34 / $120.31	Professional	26	$48.70	$75.34	$120.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.14 / $127.56 / $217.35	Professional	TC	$68.14	$127.56	$217.35
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $120.35 / $211.37 / $396.44	Professional		$120.35	$211.37	$396.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.44 / $76.87 / $137.16	Professional	26	$44.44	$76.87	$137.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $75.91 / $133.32 / $250.06	Professional	TC	$75.91	$133.32	$250.06
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $142.31 / $225.36	Professional		$107.15	$142.31	$225.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.35 / $54.38 / $110.54	Professional	26	$42.35	$54.38	$110.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.80 / $89.77 / $186.87	Professional	TC	$64.80	$89.77	$186.87
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $90.19 / $106.38 / $159.10	Professional		$90.19	$106.38	$159.10
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $32.33 / $38.74 / $52.42	Professional	26	$32.33	$38.74	$52.42
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $57.34 / $68.58 / $98.08	Professional	TC	$57.34	$68.58	$98.08