Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.29 / $99.10 / $99.10	Facility	26	$39.29	$99.10	$99.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.50 / $96.41 / $286.36	Professional		$68.50	$96.41	$286.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.03 / $23.66 / $68.33	Professional	26	$20.03	$23.66	$68.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.47 / $72.73 / $218.03	Professional	TC	$48.47	$72.73	$218.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $233.67 / $233.67 / $233.67	Professional		$233.67	$233.67	$233.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $32.45 / $83.34	Professional	26	$20.23	$32.45	$83.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.07 / $141.05 / $199.47	Professional		$96.07	$141.05	$199.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.23 / $37.04 / $52.38	Professional	26	$25.23	$37.04	$52.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.84 / $104.00 / $147.07	Professional	TC	$70.84	$104.00	$147.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.50 / $186.51 / $308.83	Professional		$123.50	$186.51	$308.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.95 / $52.22 / $77.98	Professional	26	$31.95	$52.22	$77.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.64 / $134.62 / $229.71	Professional	TC	$92.64	$134.62	$229.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $109.98 / $190.24 / $362.29	Professional		$109.98	$190.24	$362.29
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $28.88 / $49.96 / $95.13	Professional	26	$28.88	$49.96	$95.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $81.09 / $143.82 / $267.14	Professional	TC	$81.09	$143.82	$267.14
United Facility/Professional Professional Modifier Low / Median / High Price $101.70 / $124.03 / $239.67	Professional		$101.70	$124.03	$239.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.51 / $35.79 / $73.06	Professional	26	$26.51	$35.79	$73.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.05 / $88.67 / $166.60	Professional	TC	$71.05	$88.67	$166.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $76.15 / $91.38 / $134.33	Professional		$76.15	$91.38	$134.33
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $25.13 / $34.47	Professional	26	$21.26	$25.13	$34.47
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $54.40 / $65.13 / $88.31	Professional	TC	$54.40	$65.13	$88.31