Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.92 / $65.81 / $75.50	Professional		$58.92	$65.81	$75.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.45 / $16.85 / $18.32	Professional	26	$15.45	$16.85	$18.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.07 / $50.36 / $57.18	Professional	TC	$42.07	$50.36	$57.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.00 / $62.00 / $62.00	Professional	26	$62.00	$62.00	$62.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $158.60 / $212.15	Professional		$34.85	$158.60	$212.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $33.79 / $45.21	Professional	26	$8.44	$33.79	$45.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.34 / $117.79 / $166.95	Professional	TC	$25.34	$117.79	$166.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $84.38 / $249.82	Professional		$42.35	$84.38	$249.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $19.80 / $57.00	Professional	26	$9.88	$19.80	$57.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.83 / $66.47 / $195.54	Professional	TC	$31.83	$66.47	$195.54
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $95.17 / $129.16 / $293.74	Professional		$95.17	$129.16	$293.74
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $21.48 / $29.15 / $65.84	Professional	26	$21.48	$29.15	$65.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $73.69 / $106.85 / $227.44	Professional	TC	$73.69	$106.85	$227.44
United Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $101.94 / $231.36	Professional		$61.16	$101.94	$231.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $18.86 / $24.99	Professional	26	$14.02	$18.86	$24.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.84 / $85.64 / $293.08	Professional	TC	$53.84	$85.64	$293.08
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $77.93 / $93.52 / $137.47	Professional		$77.93	$93.52	$137.47
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $20.88 / $28.02	Professional	26	$17.39	$20.88	$28.02
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $72.03 / $97.44	Professional	TC	$60.10	$72.03	$97.44