Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $53.70 / $134.90	Facility	26	$36.31	$53.70	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $251.19	Professional		$77.62	$125.89	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $63.10 / $107.15	Professional	26	$30.90	$63.10	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $66.07 / $213.80	Professional	TC	$47.86	$66.07	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $104.71 / $257.04	Professional		$61.66	$104.71	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $53.70 / $117.49	Professional	26	$39.81	$53.70	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $85.11 / $112.20	Professional	TC	$67.61	$85.11	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $138.04 / $186.21	Professional		$93.33	$138.04	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $72.44	Professional	26	$35.48	$52.48	$72.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $85.11 / $114.82	Professional	TC	$57.54	$85.11	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $275.42	Professional		$107.15	$169.82	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $104.71	Professional	26	$41.69	$64.57	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $107.15 / $169.82	Professional	TC	$67.61	$107.15	$169.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $245.47	Professional		$107.15	$165.96	$245.47
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $63.10 / $93.33	Professional	26	$41.69	$63.10	$93.33
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $102.33 / $151.36	Professional	TC	$67.61	$102.33	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $257.04	Professional		$102.33	$128.82	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $95.50	Professional	26	$38.02	$48.98	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $81.28 / $158.49	Professional	TC	$63.10	$81.28	$158.49