Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.46 / $43.14 / $95.93	Facility	26	$30.46	$43.14	$95.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.78 / $207.36 / $470.45	Professional		$190.78	$207.36	$470.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.46 / $37.28 / $87.29	Professional	26	$30.46	$37.28	$87.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.75 / $171.43 / $451.72	Professional	TC	$161.75	$171.43	$451.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $194.16 / $194.16	Professional		$139.16	$194.16	$194.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $30.29 / $86.15	Professional	26	$27.57	$30.29	$86.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.67 / $102.67 / $102.67	Professional	TC	$102.67	$102.67	$102.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.79 / $206.25 / $362.44	Professional		$181.79	$206.25	$362.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $41.10 / $65.59	Professional	26	$36.22	$41.10	$65.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.56 / $165.15 / $273.64	Professional	TC	$145.56	$165.15	$273.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.89 / $358.46 / $526.44	Professional		$213.89	$358.46	$526.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.98 / $56.29 / $100.86	Professional	26	$40.98	$56.29	$100.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.29 / $294.07 / $425.58	Professional	TC	$172.29	$294.07	$425.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $208.11 / $369.06 / $685.54	Professional		$208.11	$369.06	$685.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $71.73 / $128.00	Professional	26	$41.47	$71.73	$128.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $166.64 / $292.67 / $514.33	Professional	TC	$166.64	$292.67	$514.33
United Facility/Professional Professional Modifier Low / Median / High Price $222.37 / $337.14 / $684.64	Professional		$222.37	$337.14	$684.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $63.60 / $134.82	Professional	26	$40.78	$63.60	$134.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.55 / $274.12 / $550.90	Professional	TC	$169.55	$274.12	$550.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $171.36 / $199.81 / $293.89	Professional		$171.36	$199.81	$293.89
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $35.10 / $45.78	Professional	26	$27.46	$35.10	$45.78
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $130.63 / $161.97 / $247.41	Professional	TC	$130.63	$161.97	$247.41