Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.20 / $159.86 / $214.75	Facility	26	$52.20	$159.86	$214.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.68 / $153.63 / $453.25	Professional		$96.68	$153.63	$453.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.39 / $52.20 / $164.82	Professional	26	$42.39	$52.20	$164.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.30 / $101.43 / $307.16	Professional	TC	$54.30	$101.43	$307.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.07 / $85.63 / $219.93	Professional	26	$51.07	$85.63	$219.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.27 / $179.51 / $260.27	Professional		$122.27	$179.51	$260.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.63 / $97.83 / $138.10	Professional	26	$66.63	$97.83	$138.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.64 / $87.54 / $120.70	Professional	TC	$55.64	$87.54	$120.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.48 / $315.70 / $447.03	Professional		$167.48	$315.70	$447.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.83 / $134.85 / $209.72	Professional	26	$82.83	$134.85	$209.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.03 / $164.08 / $297.97	Professional	TC	$79.03	$164.08	$297.97
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $248.75 / $432.02	Professional		$139.97	$248.75	$432.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $76.28 / $145.69 / $251.27	Professional	26	$76.28	$145.69	$251.27
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $63.69 / $126.35 / $209.80	Professional	TC	$63.69	$126.35	$209.80
United Facility/Professional Professional Modifier Low / Median / High Price $189.26 / $214.67 / $429.05	Professional		$189.26	$214.67	$429.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.39 / $98.53 / $159.84	Professional	26	$57.39	$98.53	$159.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.45 / $116.92 / $303.04	Professional	TC	$97.45	$116.92	$303.04
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $119.34 / $143.21 / $210.52	Professional		$119.34	$143.21	$210.52
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $65.30 / $85.17	Professional	26	$51.10	$65.30	$85.17
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $62.11 / $75.06 / $118.49	Professional	TC	$62.11	$75.06	$118.49