Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.04 / $83.98 / $83.98	Professional		$69.04	$83.98	$83.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.04 / $48.03 / $148.28	Professional	26	$46.04	$48.03	$148.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $35.96 / $35.96	Professional	TC	$23.00	$35.96	$35.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $29.23 / $29.23	Professional	26	$29.23	$29.23	$29.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $150.43 / $201.23	Professional		$37.79	$150.43	$201.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $97.56 / $130.50	Professional	26	$24.64	$97.56	$130.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.15 / $52.87 / $70.72	Professional	TC	$13.15	$52.87	$70.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $92.81 / $255.06	Professional		$43.89	$92.81	$255.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $59.82 / $164.38	Professional	26	$29.23	$59.82	$164.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.18 / $33.00 / $90.68	Professional	TC	$14.18	$33.00	$90.68
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $127.37 / $312.01	Professional		$101.09	$127.37	$312.01
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $83.51 / $204.57	Professional	26	$66.28	$83.51	$204.57
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.81 / $47.24 / $107.44	Professional	TC	$34.81	$47.24	$107.44
United Facility/Professional Professional Modifier Low / Median / High Price $61.71 / $92.03 / $164.61	Professional		$61.71	$92.03	$164.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.72 / $65.31 / $115.92	Professional	26	$39.72	$65.31	$115.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.69 / $27.81 / $37.19	Professional	TC	$16.69	$27.81	$37.19
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $70.83 / $85.02 / $132.22	Professional		$70.83	$85.02	$132.22
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $49.35 / $59.22 / $79.56	Professional	26	$49.35	$59.22	$79.56
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $21.40 / $26.17 / $39.26	Professional	TC	$21.40	$26.17	$39.26