Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.47 / $62.67 / $62.67	Facility	26	$33.47	$62.67	$62.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.82 / $181.63 / $502.90	Professional		$132.82	$181.63	$502.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $22.97 / $56.95	Professional	26	$20.23	$22.97	$56.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.85 / $161.38 / $449.63	Professional	TC	$109.85	$161.38	$449.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.84 / $18.84 / $18.84	Professional	26	$18.84	$18.84	$18.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.04 / $135.06 / $237.81	Professional		$119.04	$135.06	$237.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $25.32 / $41.00	Professional	26	$22.32	$25.32	$41.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.72 / $109.73 / $193.29	Professional	TC	$96.72	$109.73	$193.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.03 / $229.19 / $345.32	Professional		$140.03	$229.19	$345.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.38 / $35.82 / $62.84	Professional	26	$25.38	$35.82	$62.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.47 / $191.66 / $282.48	Professional	TC	$114.47	$191.66	$282.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $136.27 / $228.35 / $448.89	Professional		$136.27	$228.35	$448.89
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $42.18 / $78.86	Professional	26	$25.55	$42.18	$78.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $110.72 / $191.52 / $341.74	Professional	TC	$110.72	$191.52	$341.74
United Facility/Professional Professional Modifier Low / Median / High Price $149.51 / $236.50 / $445.22	Professional		$149.51	$236.50	$445.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $40.53 / $87.96	Professional	26	$25.98	$40.53	$87.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.74 / $181.12 / $359.59	Professional	TC	$120.74	$181.12	$359.59
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $114.20 / $132.37 / $196.64	Professional		$114.20	$132.37	$196.64
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $22.17 / $28.92	Professional	26	$18.16	$22.17	$28.92
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $84.54 / $104.83 / $160.12	Professional	TC	$84.54	$104.83	$160.12