Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.37 / $186.65 / $745.20	Professional		$56.37	$186.65	$745.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.76 / $79.73 / $892.26	Professional	26	$27.76	$79.73	$892.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.31 / $28.19 / $44.33	Professional	52	$26.31	$28.19	$44.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $63.85 / $248.85	Professional	TC	$24.92	$63.85	$248.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $115.88 / $115.88	Professional	26	$17.63	$115.88	$115.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $111.73 / $173.22	Professional		$28.79	$111.73	$173.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.95 / $58.86 / $91.26	Professional	26	$14.95	$58.86	$91.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.84 / $52.87 / $81.97	Professional	TC	$13.84	$52.87	$81.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.50 / $71.00 / $200.77	Professional		$35.50	$71.00	$200.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $36.28 / $137.75	Professional	26	$17.63	$36.28	$137.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $35.74 / $113.45	Professional	TC	$17.87	$35.74	$113.45
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $108.05 / $245.72	Professional		$75.31	$108.05	$245.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $57.99 / $123.43	Professional	26	$39.99	$57.99	$123.43
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $39.61 / $57.45 / $122.29	Professional	TC	$39.61	$57.45	$122.29
United Facility/Professional Professional Modifier Low / Median / High Price $43.97 / $73.28 / $128.31	Professional		$43.97	$73.28	$128.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $39.83 / $69.73	Professional	26	$23.90	$39.83	$69.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.90 / $46.04 / $114.26	Professional	TC	$22.90	$46.04	$114.26
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $61.01 / $76.31 / $111.38	Professional		$61.01	$76.31	$111.38
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $35.65 / $47.83	Professional	26	$29.71	$35.65	$47.83
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $21.40 / $28.89 / $82.50	Professional	52	$21.40	$28.89	$82.50
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $25.75 / $31.93 / $65.88	Professional	TC	$25.75	$31.93	$65.88