Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.32 / $37.32 / $54.42	Facility	26	$37.32	$37.32	$54.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $133.90 / $312.27	Professional		$110.05	$133.90	$312.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.77 / $34.17 / $83.57	Professional	26	$27.77	$34.17	$83.57
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $119.66 / $119.66 / $119.66	Professional	52	$119.66	$119.66	$119.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $92.01 / $143.53	Professional	TC	$82.29	$92.01	$143.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.51 / $132.82 / $302.93	Professional		$95.51	$132.82	$302.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.72 / $40.38 / $83.28	Professional	26	$26.72	$40.38	$83.28
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $75.73 / $75.73 / $75.73	Professional	52	$75.73	$75.73	$75.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $219.65 / $219.65 / $219.65	Professional	TC	$219.65	$219.65	$219.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.53 / $182.84 / $262.17	Professional		$124.53	$182.84	$262.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.93 / $51.29 / $72.53	Professional	26	$34.93	$51.29	$72.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.60 / $131.55 / $186.90	Professional	TC	$89.60	$131.55	$186.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.03 / $265.69 / $391.81	Professional		$166.03	$265.69	$391.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.48 / $72.33 / $106.97	Professional	26	$44.48	$72.33	$106.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.38 / $191.30 / $284.83	Professional	TC	$120.38	$191.30	$284.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $142.57 / $237.38 / $469.64	Professional		$142.57	$237.38	$469.64
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $65.78 / $123.43	Professional	26	$39.99	$65.78	$123.43
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $102.57 / $177.43 / $337.88	Professional	TC	$102.57	$177.43	$337.88
United Facility/Professional Professional Modifier Low / Median / High Price $160.16 / $215.82 / $427.32	Professional		$160.16	$215.82	$427.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.05 / $50.78 / $122.58	Professional	26	$43.05	$50.78	$122.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.65 / $135.38 / $276.08	Professional	TC	$115.65	$135.38	$276.08
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $201.08 / $3,000.00	Professional		$148.94	$201.08	$3,000.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $42.48 / $49.98 / $75.48	Professional	26	$42.48	$49.98	$75.48
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $105.39 / $123.99 / $187.27	Professional	TC	$105.39	$123.99	$187.27