Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $45.11	Facility	26	$23.44	$23.44	$45.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.95 / $221.90 / $247.09	Professional		$200.95	$221.90	$247.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $20.60 / $23.45	Professional	26	$17.98	$20.60	$23.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.97 / $201.28 / $223.64	Professional	TC	$182.97	$201.28	$223.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.95 / $17.95 / $17.95	Professional	26	$17.95	$17.95	$17.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.34 / $304.41 / $441.39	Professional		$207.34	$304.41	$441.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $32.77 / $47.51	Professional	26	$22.32	$32.77	$47.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $185.02 / $271.64 / $393.87	Professional	TC	$185.02	$271.64	$393.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.64 / $519.91 / $695.89	Professional		$277.64	$519.91	$695.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.17 / $52.51 / $68.00	Professional	26	$29.17	$52.51	$68.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.48 / $467.41 / $629.85	Professional	TC	$248.48	$467.41	$629.85
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $241.42 / $421.84 / $935.58	Professional		$241.42	$421.84	$935.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $45.31 / $84.16	Professional	26	$25.94	$45.31	$84.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $215.01 / $375.62 / $697.72	Professional	TC	$215.01	$375.62	$697.72
United Facility/Professional Professional Modifier Low / Median / High Price $306.89 / $319.27 / $446.90	Professional		$306.89	$319.27	$446.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $31.24 / $89.41	Professional	26	$25.24	$31.24	$89.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $278.30 / $281.66 / $649.26	Professional	TC	$278.30	$281.66	$649.26
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $197.28 / $244.63 / $3,000.00	Professional		$197.28	$244.63	$3,000.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $21.82 / $32.95	Professional	26	$18.55	$21.82	$32.95
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $177.31 / $208.60 / $315.05	Professional	TC	$177.31	$208.60	$315.05