Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $316.23	Professional		$117.49	$154.88	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $112.20 / $851.14	Professional	26	$57.54	$112.20	$851.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $93.33 / $173.78	Professional	TC	$61.66	$93.33	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $83.18 / $199.53	Professional	26	$48.98	$83.18	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $251.19	Professional		$125.89	$177.83	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $120.23	Professional	26	$60.26	$83.18	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $131.83	Professional	TC	$66.07	$91.20	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $281.84 / $426.58	Professional		$154.88	$281.84	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $131.83 / $181.97	Professional	26	$72.44	$131.83	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $147.91 / $257.04	Professional	TC	$85.11	$147.91	$257.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $251.19 / $389.05	Professional		$141.25	$251.19	$389.05
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $181.97	Professional	26	$70.79	$123.03	$181.97
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $131.83 / $199.53	Professional	TC	$79.43	$131.83	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $426.58	Professional		$158.49	$204.17	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $79.43 / $177.83	Professional	26	$60.26	$79.43	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $104.71 / $204.17	Professional	TC	$83.18	$104.71	$204.17
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67