Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $102.33 / $213.80	Facility	26	$52.48	$102.33	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $309.03	Professional		$128.82	$169.82	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $181.97	Professional	26	$52.48	$85.11	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $218.78	Professional	TC	$67.61	$95.50	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $223.87	Professional	26	$85.11	$87.10	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $316.23	Professional		$123.03	$199.53	$316.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $102.33 / $141.25	Professional	26	$67.61	$102.33	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $89.13 / $144.54	Professional	TC	$56.23	$89.13	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $316.23 / $489.78	Professional		$162.18	$316.23	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $114.82 / $204.17	Professional	26	$75.86	$114.82	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $151.36 / $316.23	Professional	TC	$77.62	$151.36	$316.23
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $218.78 / $331.13	Professional		$134.90	$218.78	$331.13
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $123.03 / $181.97	Professional	26	$77.62	$123.03	$181.97
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $107.15 / $154.88	Professional	TC	$64.57	$107.15	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $398.11	Professional		$147.91	$218.78	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $95.50 / $169.82	Professional	26	$57.54	$95.50	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $112.20 / $263.03	Professional	TC	$67.61	$112.20	$263.03
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $51.29 / $51.29	Facility	26	$43.65	$51.29	$51.29