Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.72 / $48.25 / $124.80	Facility	26	$33.72	$48.25	$124.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.37 / $127.29 / $357.25	Professional		$97.37	$127.29	$357.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.90 / $33.72 / $95.60	Professional	26	$25.90	$33.72	$95.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $48.69 / $63.65 / $69.97	Professional	52	$48.69	$63.65	$69.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.47 / $93.56 / $261.64	Professional	TC	$71.47	$93.56	$261.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.62 / $134.65 / $277.74	Professional		$87.62	$134.65	$277.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $36.65 / $104.84	Professional	26	$24.04	$36.65	$104.84
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $21.90 / $21.90 / $21.90	Professional	52	$21.90	$21.90	$21.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.24 / $102.24 / $102.24	Professional	TC	$102.24	$102.24	$102.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.18 / $128.04 / $216.21	Professional		$114.18	$128.04	$216.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $34.79 / $59.43	Professional	26	$31.70	$34.79	$59.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.48 / $92.77 / $152.59	Professional	TC	$82.48	$92.77	$152.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.55 / $215.67 / $372.50	Professional		$140.55	$215.67	$372.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.56 / $61.58 / $98.27	Professional	26	$39.56	$61.58	$98.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.27 / $154.09 / $268.24	Professional	TC	$94.27	$154.09	$268.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $130.77 / $231.82 / $430.60	Professional		$130.77	$231.82	$430.60
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $59.91 / $112.01	Professional	26	$36.29	$59.91	$112.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $94.43 / $163.34 / $291.45	Professional	TC	$94.43	$163.34	$291.45
United Facility/Professional Professional Modifier Low / Median / High Price $117.21 / $160.66 / $524.96	Professional		$117.21	$160.66	$524.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $46.46 / $85.82	Professional	26	$35.07	$46.46	$85.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.70 / $121.71 / $238.53	Professional	TC	$87.70	$121.71	$238.53
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $98.70 / $115.28 / $174.11	Professional		$98.70	$115.28	$174.11
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $31.62 / $42.77	Professional	26	$26.38	$31.62	$42.77
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $20.00 / $20.00 / $27.00	Professional	52	$20.00	$20.00	$27.00
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $71.59 / $84.24 / $119.98	Professional	TC	$71.59	$84.24	$119.98