Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.43 / $128.41 / $252.68	Facility	26	$77.43	$128.41	$252.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.53 / $229.24 / $596.39	Professional		$214.53	$229.24	$596.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.86 / $77.43 / $200.79	Professional	26	$67.86	$77.43	$200.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.65 / $148.83 / $395.59	Professional	TC	$141.65	$148.83	$395.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $216.25 / $216.25 / $216.25	Professional	26	$216.25	$216.25	$216.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.94 / $383.02 / $641.88	Professional		$176.94	$383.02	$641.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.34 / $137.44 / $237.04	Professional	26	$65.34	$137.44	$237.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.60 / $234.73 / $404.84	Professional	TC	$111.60	$234.73	$404.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.27 / $355.78 / $545.60	Professional		$219.27	$355.78	$545.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.56 / $130.26 / $194.89	Professional	26	$84.56	$130.26	$194.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.43 / $229.26 / $351.09	Professional	TC	$130.43	$229.26	$351.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $202.55 / $350.37 / $667.22	Professional		$202.55	$350.37	$667.22
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $74.80 / $132.65 / $230.87	Professional	26	$74.80	$132.65	$230.87
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $127.75 / $224.37 / $394.30	Professional	TC	$127.75	$224.37	$394.30
United Facility/Professional Professional Modifier Low / Median / High Price $193.17 / $294.54 / $597.92	Professional		$193.17	$294.54	$597.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.95 / $122.74 / $220.34	Professional	26	$77.95	$122.74	$220.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.54 / $196.74 / $398.25	Professional	TC	$120.54	$196.74	$398.25
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $165.19 / $198.23 / $286.85	Professional		$165.19	$198.23	$286.85
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $54.74 / $67.88 / $92.57	Professional	26	$54.74	$67.88	$92.57
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $96.71 / $116.05 / $170.60	Professional	TC	$96.71	$116.05	$170.60