Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $190.55 / $309.03	Facility	26	$93.33	$190.55	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $851.14	Professional		$213.80	$281.84	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $114.82 / $288.40	Professional	26	$77.62	$114.82	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $181.97 / $501.19	Professional	TC	$147.91	$181.97	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $537.03	Professional		$218.78	$218.78	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $109.65 / $125.89	Professional	26	$91.20	$109.65	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	TC	$223.87	$223.87	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $588.84 / $831.76	Professional		$234.42	$588.84	$831.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $208.93 / $295.12	Professional	26	$81.28	$208.93	$295.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $389.05 / $537.03	Professional	TC	$151.36	$389.05	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $676.08	Professional		$275.42	$446.68	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $151.36 / $239.88	Professional	26	$95.50	$151.36	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $457.09	Professional	TC	$169.82	$281.84	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $416.87 / $616.60	Professional		$269.15	$416.87	$616.60
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $144.54 / $213.80	Professional	26	$95.50	$144.54	$213.80
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $275.42 / $407.38	Professional	TC	$177.83	$275.42	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $741.31	Professional		$257.04	$398.11	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $141.25 / $257.04	Professional	26	$89.13	$141.25	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $263.03 / $478.63	Professional	TC	$165.96	$263.03	$478.63