Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.49 / $116.90 / $133.82	Professional		$85.49	$116.90	$133.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $65.81 / $81.98	Professional	26	$65.37	$65.81	$81.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $51.09 / $51.09	Professional	TC	$20.12	$51.09	$51.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $276.77 / $276.77 / $276.77	Professional	26	$276.77	$276.77	$276.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $179.32 / $253.59	Professional		$45.68	$179.32	$253.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.74 / $136.80 / $182.99	Professional	26	$34.74	$136.80	$182.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.94 / $42.51 / $60.11	Professional	TC	$10.94	$42.51	$60.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.12 / $116.54 / $320.25	Professional		$57.12	$116.54	$320.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.10 / $84.19 / $236.20	Professional	26	$42.10	$84.19	$236.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.03 / $30.06 / $95.71	Professional	TC	$15.03	$30.06	$95.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $128.86 / $186.85 / $397.73	Professional		$128.86	$186.85	$397.73
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $138.53 / $294.88	Professional	26	$95.54	$138.53	$294.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $33.33 / $48.33 / $102.87	Professional	TC	$33.33	$48.33	$102.87
United Facility/Professional Professional Modifier Low / Median / High Price $59.36 / $117.65 / $162.36	Professional		$59.36	$117.65	$162.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.17 / $90.95 / $161.00	Professional	26	$55.17	$90.95	$161.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.69 / $27.81 / $48.70	Professional	TC	$16.69	$27.81	$48.70
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $98.73 / $121.10 / $170.19	Professional		$98.73	$121.10	$170.19
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.29 / $81.95 / $110.21	Professional	26	$68.29	$81.95	$110.21
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $21.40 / $26.75 / $62.96	Professional	TC	$21.40	$26.75	$62.96