Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $208.93	Professional		$64.57	$79.43	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $46.77 / $123.03	Professional	26	$33.88	$46.77	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $89.13	Professional	TC	$19.95	$36.31	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $95.50	Professional		$87.10	$87.10	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $125.89 / $229.09	Professional		$70.79	$125.89	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $87.10	Professional	26	$35.48	$35.48	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $35.48 / $89.13	Professional	TC	$21.38	$35.48	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $213.80	Professional		$81.28	$123.03	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $104.71	Professional	26	$44.67	$67.61	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $52.48 / $107.15	Professional	TC	$30.20	$52.48	$107.15
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $186.21	Professional		$74.13	$114.82	$186.21
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $95.50	Professional	26	$38.90	$53.70	$95.50
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $57.54 / $93.33	Professional	TC	$38.90	$57.54	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $107.15 / $194.98	Professional		$66.07	$107.15	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $63.10 / $117.49	Professional	26	$38.02	$63.10	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $44.67 / $93.33	Professional	TC	$27.54	$44.67	$93.33
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $26.92 / $45.71	Facility	26	$22.91	$26.92	$45.71