Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $33.88 / $69.18	Facility	26	$19.05	$33.88	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $109.65 / $281.84	Professional		$81.28	$109.65	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $57.54	Professional	26	$15.14	$20.42	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $208.93	Professional	TC	$63.10	$87.10	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $72.44	Professional		$70.79	$70.79	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.95 / $57.54	Professional	26	$13.80	$19.95	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $223.87	Professional		$97.72	$151.36	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $28.18 / $39.81	Professional	26	$17.78	$28.18	$39.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $123.03 / $181.97	Professional	TC	$81.28	$123.03	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $154.88 / $302.00	Professional		$125.89	$154.88	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $35.48 / $51.29	Professional	26	$21.38	$35.48	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $257.04	Professional	TC	$95.50	$131.83	$257.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $263.03	Professional		$114.82	$177.83	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $32.36 / $46.77	Professional	26	$20.42	$32.36	$46.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $147.91 / $218.78	Professional	TC	$95.50	$147.91	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $234.42	Professional		$95.50	$131.83	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $24.55 / $47.86	Professional	26	$18.62	$24.55	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $107.15 / $194.98	Professional	TC	$77.62	$107.15	$194.98
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $13.18 / $13.18	Facility	26	$10.96	$13.18	$13.18