Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.78 / $54.54 / $137.97	Facility	26	$37.78	$54.54	$137.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.58 / $93.04 / $274.55	Professional		$69.58	$93.04	$274.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.26 / $37.79 / $98.30	Professional	26	$29.26	$37.79	$98.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.32 / $55.25 / $155.34	Professional	TC	$40.32	$55.25	$155.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.95 / $97.67 / $201.45	Professional		$67.95	$97.67	$201.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $40.64 / $115.69	Professional	26	$27.74	$40.64	$115.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.70 / $59.70 / $59.70	Professional	TC	$59.70	$59.70	$59.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.13 / $122.05 / $171.12	Professional		$83.13	$122.05	$171.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.93 / $51.29 / $71.91	Professional	26	$34.93	$51.29	$71.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.20 / $70.76 / $99.21	Professional	TC	$48.20	$70.76	$99.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.94 / $161.82 / $259.83	Professional		$106.94	$161.82	$259.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $68.80 / $109.34	Professional	26	$43.82	$68.80	$109.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.13 / $97.14 / $149.71	Professional	TC	$63.13	$97.14	$149.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $95.17 / $158.46 / $313.50	Professional		$95.17	$158.46	$313.50
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $67.01 / $131.72	Professional	26	$39.99	$67.01	$131.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $55.17 / $95.43 / $170.28	Professional	TC	$55.17	$95.43	$170.28
United Facility/Professional Professional Modifier Low / Median / High Price $95.17 / $112.87 / $225.06	Professional		$95.17	$112.87	$225.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.69 / $48.78 / $99.11	Professional	26	$37.69	$48.78	$99.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.36 / $70.04 / $117.63	Professional	TC	$56.36	$70.04	$117.63
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $82.73 / $121.61	Professional		$68.94	$82.73	$121.61
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $29.36 / $35.19 / $47.61	Professional	26	$29.36	$35.19	$47.61
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $39.36 / $46.85 / $67.42	Professional	TC	$39.36	$46.85	$67.42