Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.44 / $376.87 / $376.87	Facility	26	$163.44	$376.87	$376.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.63 / $202.61 / $750.93	Professional		$117.63	$202.61	$750.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.19 / $103.13 / $289.08	Professional	26	$79.19	$103.13	$289.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.44 / $99.48 / $461.84	Professional	TC	$38.44	$99.48	$461.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $102.32 / $250.13 / $250.13	Professional	26	$102.32	$250.13	$250.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.32 / $202.14 / $293.10	Professional		$142.32	$202.14	$293.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.48 / $148.38 / $215.16	Professional	26	$104.48	$148.38	$215.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.85 / $53.75 / $77.93	Professional	TC	$37.85	$53.75	$77.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.84 / $294.02 / $534.57	Professional		$187.84	$294.02	$534.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.16 / $219.89 / $319.07	Professional	26	$129.16	$219.89	$319.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $73.38 / $151.52	Professional	TC	$50.76	$73.38	$151.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $163.00 / $310.41 / $579.69	Professional		$163.00	$310.41	$579.69
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $119.66 / $212.57 / $394.01	Professional	26	$119.66	$212.57	$394.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $43.35 / $77.01 / $133.74	Professional	TC	$43.35	$77.01	$133.74
United Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $215.13 / $633.46	Professional		$167.09	$215.13	$633.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.18 / $139.33 / $242.49	Professional	26	$102.18	$139.33	$242.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $35.18 / $401.91	Professional	TC	$32.47	$35.18	$401.91
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $104.41 / $143.66 / $209.26	Professional		$104.41	$143.66	$209.26
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $82.99 / $97.43 / $134.57	Professional	26	$82.99	$97.43	$134.57
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $25.82 / $114.28	Professional	TC	$20.82	$25.82	$114.28