Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.45 / $130.83 / $130.83	Facility	26	$48.45	$130.83	$130.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.91 / $132.03 / $367.04	Professional		$73.91	$132.03	$367.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.86 / $32.46 / $90.23	Professional	26	$24.86	$32.46	$90.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.06 / $98.44 / $276.80	Professional	TC	$49.06	$98.44	$276.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.88 / $194.48 / $197.29	Professional		$144.88	$194.48	$197.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $24.70 / $73.36	Professional	26	$24.70	$24.70	$73.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.15 / $211.44 / $286.14	Professional		$137.15	$211.44	$286.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.05 / $34.33 / $57.35	Professional	26	$31.05	$34.33	$57.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.10 / $175.09 / $239.50	Professional	TC	$106.10	$175.09	$239.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.85 / $293.83 / $618.52	Professional		$159.85	$293.83	$618.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.93 / $59.80 / $96.10	Professional	26	$38.93	$59.80	$96.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.36 / $244.66 / $522.36	Professional	TC	$111.36	$244.66	$522.36
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $218.11 / $386.80 / $718.48	Professional		$218.11	$386.80	$718.48
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $61.49 / $109.73	Professional	26	$35.54	$61.49	$109.73
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $182.56 / $315.79 / $563.47	Professional	TC	$182.56	$315.79	$563.47
United Facility/Professional Professional Modifier Low / Median / High Price $136.86 / $198.58 / $363.15	Professional		$136.86	$198.58	$363.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $41.57 / $74.20	Professional	26	$34.64	$41.57	$74.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.09 / $162.50 / $238.62	Professional	TC	$109.09	$162.50	$238.62
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $135.30 / $204.34	Professional		$115.84	$135.30	$204.34
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $30.90 / $41.45	Professional	26	$25.75	$30.90	$41.45
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $84.54 / $105.23 / $145.04	Professional	TC	$84.54	$105.23	$145.04