Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.42 / $53.48 / $134.02	Facility	26	$36.42	$53.48	$134.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.64 / $100.03 / $364.82	Professional		$76.64	$100.03	$364.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.46 / $36.43 / $90.77	Professional	26	$28.46	$36.43	$90.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.18 / $63.61 / $178.83	Professional	TC	$48.18	$63.61	$178.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $104.63 / $254.23	Professional		$68.59	$104.63	$254.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.32 / $39.68 / $113.42	Professional	26	$26.32	$39.68	$113.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.78 / $67.78 / $67.78	Professional	TC	$67.78	$67.78	$67.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.95 / $130.60 / $183.11	Professional		$88.95	$130.60	$183.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $50.34 / $70.58	Professional	26	$34.29	$50.34	$70.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.67 / $80.26 / $112.53	Professional	TC	$54.67	$80.26	$112.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.53 / $178.63 / $286.95	Professional		$114.53	$178.63	$286.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.95 / $66.83 / $106.87	Professional	26	$42.95	$66.83	$106.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.58 / $110.47 / $178.85	Professional	TC	$71.58	$110.47	$178.85
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $101.83 / $180.97 / $335.44	Professional		$101.83	$180.97	$335.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.25 / $67.89 / $121.15	Professional	26	$39.25	$67.89	$121.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $62.58 / $104.20 / $206.14	Professional	TC	$62.58	$104.20	$206.14
United Facility/Professional Professional Modifier Low / Median / High Price $103.65 / $125.17 / $249.70	Professional		$103.65	$125.17	$249.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $47.43 / $72.68	Professional	26	$37.65	$47.43	$72.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.73 / $74.55 / $137.13	Professional	TC	$62.73	$74.55	$137.13
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $91.48 / $134.47	Professional		$76.23	$91.48	$134.47
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $28.54 / $34.21 / $46.28	Professional	26	$28.54	$34.21	$46.28
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $47.49 / $56.52 / $81.05	Professional	TC	$47.49	$56.52	$81.05