Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.03 / $49.03 / $87.56	Facility	26	$49.03	$49.03	$87.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.07 / $154.33 / $387.14	Professional		$136.07	$154.33	$387.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.43 / $44.82 / $86.54	Professional	26	$36.43	$44.82	$86.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.64 / $111.43 / $131.55	Professional	TC	$99.64	$111.43	$131.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.91 / $163.81 / $373.61	Professional		$117.91	$163.81	$373.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $52.38 / $149.75	Professional	26	$36.15	$52.38	$149.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $265.57 / $265.57 / $265.57	Professional	TC	$265.57	$265.57	$265.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $225.58 / $323.45	Professional		$153.65	$225.58	$323.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $66.48 / $94.03	Professional	26	$45.29	$66.48	$94.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.36 / $159.09 / $226.33	Professional	TC	$108.36	$159.09	$226.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.76 / $327.79 / $485.37	Professional		$204.76	$327.79	$485.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.64 / $93.83 / $139.97	Professional	26	$58.64	$93.83	$139.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.54 / $232.12 / $345.40	Professional	TC	$145.54	$232.12	$345.40
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $175.89 / $312.58 / $579.40	Professional		$175.89	$312.58	$579.40
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $89.67 / $170.77	Professional	26	$51.84	$89.67	$170.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $124.05 / $217.87 / $408.63	Professional	TC	$124.05	$217.87	$408.63
United Facility/Professional Professional Modifier Low / Median / High Price $188.97 / $238.40 / $527.51	Professional		$188.97	$238.40	$527.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.39 / $66.23 / $126.75	Professional	26	$55.39	$66.23	$126.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.05 / $155.97 / $324.13	Professional	TC	$140.05	$155.97	$324.13
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $182.57 / $3,000.00	Professional		$135.24	$182.57	$3,000.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $38.20 / $44.94 / $67.88	Professional	26	$38.20	$44.94	$67.88
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $96.07 / $113.02 / $170.68	Professional	TC	$96.07	$113.02	$170.68