Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $89.49 / $526.50	Professional		$77.22	$89.49	$526.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $21.38 / $236.70	Professional	26	$19.75	$21.38	$236.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.62 / $61.88 / $91.56	Professional	TC	$56.62	$61.88	$91.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.56 / $12.56 / $82.58	Professional	26	$12.56	$12.56	$82.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.74 / $176.59 / $273.77	Professional		$39.74	$176.59	$273.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.52 / $41.97 / $65.06	Professional	26	$10.52	$41.97	$65.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $134.62 / $208.71	Professional	TC	$28.51	$134.62	$208.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $104.66 / $317.77	Professional		$45.71	$104.66	$317.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.56 / $25.85 / $71.03	Professional	26	$12.56	$25.85	$71.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.04 / $85.11 / $246.74	Professional	TC	$33.04	$85.11	$246.74
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $124.05 / $168.36 / $382.88	Professional		$124.05	$168.36	$382.88
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $38.69 / $87.39	Professional	26	$28.51	$38.69	$87.39
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $95.54 / $138.53 / $294.88	Professional	TC	$95.54	$138.53	$294.88
United Facility/Professional Professional Modifier Low / Median / High Price $66.50 / $132.55 / $368.41	Professional		$66.50	$132.55	$368.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.87 / $28.12 / $49.24	Professional	26	$16.87	$28.12	$49.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.63 / $82.71 / $144.82	Professional	TC	$49.63	$82.71	$144.82
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $84.67 / $101.60 / $149.36	Professional		$84.67	$101.60	$149.36
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $25.14 / $33.72	Professional	26	$20.95	$25.14	$33.72
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $63.26 / $75.81 / $102.59	Professional	TC	$63.26	$75.81	$102.59