Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.12 / $223.10 / $223.10	Facility	26	$92.12	$223.10	$223.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.65 / $154.75 / $422.30	Professional		$118.65	$154.75	$422.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $60.84 / $158.22	Professional	26	$46.89	$60.84	$158.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.76 / $93.91 / $264.07	Professional	TC	$71.76	$93.91	$264.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.46 / $118.18 / $297.95	Professional		$100.46	$118.18	$297.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.66 / $83.20 / $195.38	Professional	26	$57.66	$83.20	$195.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.92 / $174.57 / $253.12	Professional		$122.92	$174.57	$253.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.87 / $83.61 / $121.23	Professional	26	$58.87	$83.61	$121.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.05 / $90.96 / $131.88	Professional	TC	$64.05	$90.96	$131.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.29 / $271.22 / $426.18	Professional		$163.29	$271.22	$426.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.92 / $124.05 / $180.62	Professional	26	$75.92	$124.05	$180.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.03 / $147.02 / $256.68	Professional	TC	$86.03	$147.02	$256.68
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $140.77 / $268.08 / $500.63	Professional		$140.77	$268.08	$500.63
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $67.39 / $119.77 / $221.99	Professional	26	$67.39	$119.77	$221.99
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $73.34 / $130.30 / $241.52	Professional	TC	$73.34	$130.30	$241.52
United Facility/Professional Professional Modifier Low / Median / High Price $160.66 / $194.14 / $306.94	Professional		$160.66	$194.14	$306.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.94 / $76.31 / $137.06	Professional	26	$60.94	$76.31	$137.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.36 / $101.93 / $319.82	Professional	TC	$84.36	$101.93	$319.82
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $101.54 / $125.91 / $192.32	Professional		$101.54	$125.91	$192.32
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $47.04 / $56.38 / $76.28	Professional	26	$47.04	$56.38	$76.28
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $54.15 / $67.15 / $102.56	Professional	TC	$54.15	$67.15	$102.56