Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.65 / $83.16 / $127.60	Facility	26	$55.65	$83.16	$127.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.82 / $330.02 / $367.71	Professional		$296.82	$330.02	$367.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.41 / $49.03 / $55.66	Professional	26	$43.41	$49.03	$55.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $253.41 / $280.99 / $312.06	Professional	TC	$253.41	$280.99	$312.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.92 / $42.92 / $42.92	Professional	26	$42.92	$42.92	$42.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.70 / $447.36 / $648.66	Professional		$304.70	$447.36	$648.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.37 / $78.36 / $113.62	Professional	26	$53.37	$78.36	$113.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.33 / $369.00 / $535.04	Professional	TC	$251.33	$369.00	$535.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.35 / $762.11 / $1,035.59	Professional		$407.35	$762.11	$1,035.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.73 / $126.22 / $164.88	Professional	26	$69.73	$126.22	$164.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $337.61 / $635.89 / $878.86	Professional	TC	$337.61	$635.89	$878.86
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $354.78 / $664.57 / $1,241.07	Professional		$354.78	$664.57	$1,241.07
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.02 / $108.35 / $201.27	Professional	26	$62.02	$108.35	$201.27
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $292.06 / $510.24 / $947.78	Professional	TC	$292.06	$510.24	$947.78
United Facility/Professional Professional Modifier Low / Median / High Price $453.04 / $470.15 / $656.78	Professional		$453.04	$470.15	$656.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.91 / $72.59 / $110.96	Professional	26	$59.91	$72.59	$110.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $381.65 / $393.13 / $545.82	Professional	TC	$381.65	$393.13	$545.82
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $289.92 / $359.50 / $3,000.00	Professional		$289.92	$359.50	$3,000.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $44.62 / $52.49 / $79.27	Professional	26	$44.62	$52.49	$79.27
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $243.22 / $286.14 / $432.14	Professional	TC	$243.22	$286.14	$432.14