Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.97 / $222.50 / $222.50	Facility	26	$86.97	$222.50	$222.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.93 / $101.60 / $256.00	Professional		$87.93	$101.60	$256.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.67 / $67.13 / $121.62	Professional	26	$59.67	$67.13	$121.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.27 / $31.87 / $85.53	Professional	TC	$28.27	$31.87	$85.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.68 / $66.68 / $66.68	Professional	26	$66.68	$66.68	$66.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.92 / $207.11 / $353.16	Professional		$100.92	$207.11	$353.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.58 / $118.16 / $198.79	Professional	26	$57.58	$118.16	$198.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.34 / $88.95 / $144.22	Professional	TC	$43.34	$88.95	$144.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $176.31 / $287.58	Professional		$125.70	$176.31	$287.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.05 / $108.03 / $160.30	Professional	26	$78.05	$108.03	$160.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.63 / $67.11 / $127.29	Professional	TC	$43.63	$67.11	$127.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $92.42 / $171.04 / $356.58	Professional		$92.42	$171.04	$356.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $103.56 / $203.43	Professional	26	$65.91	$103.56	$203.43
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $48.76 / $77.97 / $153.15	Professional	TC	$48.76	$77.97	$153.15
United Facility/Professional Professional Modifier Low / Median / High Price $102.96 / $155.88 / $336.78	Professional		$102.96	$155.88	$336.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.95 / $104.50 / $160.24	Professional	26	$64.95	$104.50	$160.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.28 / $55.36 / $123.34	Professional	TC	$39.28	$55.36	$123.34
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $93.72 / $137.77	Professional		$78.09	$93.72	$137.77
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $48.88 / $61.10 / $84.18	Professional	26	$48.88	$61.10	$84.18
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.14 / $47.06	Professional	TC	$28.84	$34.14	$47.06