Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $457.09	Professional		$173.78	$263.03	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $66.07 / $85.11	Professional	26	$44.67	$66.07	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $186.21 / $398.11	Professional	TC	$128.82	$186.21	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $446.68	Professional		$223.87	$316.23	$446.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $87.10 / $125.89	Professional	26	$60.26	$87.10	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $223.87 / $323.59	Professional	TC	$162.18	$223.87	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $512.86 / $933.25	Professional		$281.84	$512.86	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $134.90 / $181.97	Professional	26	$77.62	$134.90	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $380.19 / $676.08	Professional	TC	$204.17	$380.19	$676.08
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $630.96	Professional		$257.04	$436.52	$630.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $169.82	Professional	26	$69.18	$117.49	$169.82
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $316.23 / $489.78	Professional	TC	$186.21	$316.23	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $407.38 / $741.31	Professional		$275.42	$407.38	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $181.97	Professional	26	$54.95	$81.28	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $295.12 / $616.60	Professional	TC	$199.53	$295.12	$616.60
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71