Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.47 / $106.32 / $141.94	Professional		$86.47	$106.32	$141.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.07 / $119.00 / $623.40	Professional	26	$31.07	$119.00	$623.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.40 / $65.36 / $82.91	Professional	TC	$55.40	$65.36	$82.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $19.57 / $128.74	Professional	26	$19.57	$19.57	$128.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $195.12 / $275.93	Professional		$49.00	$195.12	$275.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $65.95 / $93.26	Professional	26	$16.61	$65.95	$93.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.39 / $129.16 / $178.30	Professional	TC	$32.39	$129.16	$178.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.19 / $123.20 / $338.56	Professional		$59.19	$123.20	$338.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $40.29 / $110.73	Professional	26	$20.14	$40.29	$110.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.61 / $79.22 / $227.82	Professional	TC	$39.61	$79.22	$227.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $166.57 / $408.04	Professional		$87.76	$166.57	$408.04
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.44 / $64.44 / $137.16	Professional	26	$44.44	$64.44	$137.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $91.68 / $133.10 / $270.87	Professional	TC	$91.68	$133.10	$270.87
United Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $127.40 / $230.12	Professional		$78.84	$127.40	$230.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $44.03 / $78.05	Professional	26	$26.74	$44.03	$78.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.11 / $86.85 / $131.63	Professional	TC	$52.11	$86.85	$131.63
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $94.23 / $116.96 / $176.65	Professional		$94.23	$116.96	$176.65
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $45.72 / $62.94	Professional	26	$33.22	$45.72	$62.94
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $65.88 / $78.15 / $107.72	Professional	TC	$65.88	$78.15	$107.72