Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.18 / $126.72 / $126.72	Facility	26	$57.18	$126.72	$126.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $192.06 / $557.00	Professional		$171.22	$192.06	$557.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.43 / $34.40 / $97.29	Professional	26	$26.43	$34.40	$97.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $157.63 / $459.70	Professional	TC	$140.87	$157.63	$459.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.94 / $635.51 / $635.51	Professional		$209.94	$635.51	$635.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.78 / $51.65 / $87.50	Professional	26	$35.78	$51.65	$87.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $260.07 / $369.36 / $535.57	Professional		$260.07	$369.36	$535.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $51.91 / $75.26	Professional	26	$36.54	$51.91	$75.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.51 / $317.45 / $460.30	Professional	TC	$223.51	$317.45	$460.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $341.10 / $560.82 / $828.35	Professional		$341.10	$560.82	$828.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.52 / $78.25 / $112.45	Professional	26	$45.52	$78.25	$112.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.76 / $484.03 / $715.90	Professional	TC	$296.76	$484.03	$715.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $297.83 / $534.82 / $980.72	Professional		$297.83	$534.82	$980.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $41.86 / $75.16 / $137.83	Professional	26	$41.86	$75.16	$137.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $255.98 / $459.64 / $842.89	Professional	TC	$255.98	$459.64	$842.89
United Facility/Professional Professional Modifier Low / Median / High Price $174.53 / $352.87 / $650.55	Professional		$174.53	$352.87	$650.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $50.84 / $148.86	Professional	26	$35.61	$50.84	$148.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.93 / $316.64 / $784.35	Professional	TC	$174.93	$316.64	$784.35
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $177.98 / $259.45 / $397.99	Professional		$177.98	$259.45	$397.99
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $28.95 / $34.06 / $46.00	Professional	26	$28.95	$34.06	$46.00
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.18 / $225.93 / $325.33	Professional	TC	$146.18	$225.93	$325.33