Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.75 / $35.61 / $91.66	Facility	26	$27.75	$35.61	$91.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.66 / $115.43 / $302.07	Professional		$108.66	$115.43	$302.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $28.83 / $73.25	Professional	26	$24.48	$28.83	$73.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.42 / $86.57 / $230.18	Professional	TC	$82.42	$86.57	$230.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.85 / $229.85 / $229.85	Professional		$229.85	$229.85	$229.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.30 / $32.76 / $78.05	Professional	26	$27.30	$32.76	$78.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.45 / $203.91 / $342.65	Professional		$94.45	$203.91	$342.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $49.67 / $85.66	Professional	26	$23.61	$49.67	$85.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.84 / $149.00 / $256.98	Professional	TC	$70.84	$149.00	$256.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.78 / $192.00 / $290.29	Professional		$125.78	$192.00	$290.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.54 / $46.48 / $70.58	Professional	26	$30.54	$46.48	$70.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.11 / $143.85 / $219.71	Professional	TC	$95.11	$143.85	$219.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $108.13 / $192.17 / $356.19	Professional		$108.13	$192.17	$356.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $27.03 / $46.76 / $83.43	Professional	26	$27.03	$46.76	$83.43
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $85.16 / $161.94 / $250.32	Professional	TC	$85.16	$161.94	$250.32
United Facility/Professional Professional Modifier Low / Median / High Price $104.05 / $169.92 / $311.29	Professional		$104.05	$169.92	$311.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.28 / $45.25 / $79.87	Professional	26	$29.28	$45.25	$79.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.09 / $120.03 / $232.44	Professional	TC	$81.09	$120.03	$232.44
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $85.04 / $102.05 / $150.44	Professional		$85.04	$102.05	$150.44
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $19.77 / $24.51 / $32.94	Professional	26	$19.77	$24.51	$32.94
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $59.66 / $71.59 / $105.24	Professional	TC	$59.66	$71.59	$105.24