Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $724.44	Professional		$234.42	$323.59	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $181.97 / $549.54	Professional	26	$128.82	$181.97	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $147.91 / $338.84	Professional	TC	$109.65	$147.91	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	26	$123.03	$123.03	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $588.84	Professional		$288.40	$416.87	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $213.80 / $309.03	Professional	26	$151.36	$213.80	$309.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $190.55 / $275.42	Professional	TC	$138.04	$190.55	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $645.65 / $870.96	Professional		$354.81	$645.65	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $338.84 / $457.09	Professional	26	$181.97	$338.84	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $416.87	Professional	TC	$177.83	$302.00	$416.87
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $891.25	Professional		$338.84	$575.44	$891.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $302.00 / $457.09	Professional	26	$177.83	$302.00	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $275.42 / $416.87	Professional	TC	$162.18	$275.42	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $389.05 / $912.01	Professional		$323.59	$389.05	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $199.53 / $457.09	Professional	26	$162.18	$199.53	$457.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $426.58	Professional	TC	$154.88	$177.83	$426.58
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82