Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $42.66 / $95.50	Facility	26	$30.20	$42.66	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $602.56	Professional		$169.82	$257.04	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $114.82	Professional	26	$32.36	$46.77	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $194.98 / $512.86	Professional	TC	$138.04	$194.98	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $446.68	Professional		$128.82	$173.78	$446.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $46.77 / $120.23	Professional	26	$28.18	$46.77	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $213.80 / $302.00	Professional		$190.55	$213.80	$302.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $41.69 / $60.26	Professional	26	$37.15	$41.69	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $173.78 / $239.88	Professional	TC	$151.36	$173.78	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $338.84 / $524.81	Professional		$213.80	$338.84	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $53.70 / $97.72	Professional	26	$36.31	$53.70	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $281.84 / $457.09	Professional	TC	$173.78	$281.84	$457.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $524.81	Professional		$223.87	$338.84	$524.81
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $100.00	Professional	26	$43.65	$67.61	$100.00
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 $213.80 / $338.84 / $630.96	Professional		$213.80	$338.84	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $63.10 / $117.49	Professional	26	$40.74	$63.10	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $478.63	Professional	TC	$169.82	$281.84	$478.63