Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $251.19	Professional		$66.07	$83.18	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $131.83	Professional	26	$38.90	$57.54	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $38.02 / $85.11	Professional	TC	$21.38	$38.02	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $112.20	Professional		$66.07	$75.86	$112.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	26	$38.90	$38.90	$38.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $194.98 / $281.84	Professional		$77.62	$194.98	$281.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $95.50 / $147.91	Professional	26	$40.74	$95.50	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $91.20 / $138.04	Professional	TC	$38.02	$91.20	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $234.42	Professional		$87.10	$134.90	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $120.23	Professional	26	$51.29	$72.44	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $57.54 / $114.82	Professional	TC	$32.36	$57.54	$114.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $109.65 / $208.93	Professional		$61.66	$109.65	$208.93
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $66.07 / $112.20	Professional	26	$45.71	$66.07	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $100.00	Professional	TC	$42.66	$58.88	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $218.78	Professional		$74.13	$114.82	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $69.18 / $123.03	Professional	26	$42.66	$69.18	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $48.98 / $100.00	Professional	TC	$28.84	$48.98	$100.00
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $30.90 / $51.29	Facility	26	$26.30	$30.90	$51.29