Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $331.13	Professional		$114.82	$158.49	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.12 / $77.62	Professional	26	$20.89	$25.12	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $117.49 / $288.40	Professional	TC	$93.33	$117.49	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $141.25 / $194.98	Professional		$123.03	$141.25	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $25.70 / $36.31	Professional	26	$23.44	$25.70	$36.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $114.82 / $158.49	Professional	TC	$100.00	$114.82	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $218.78 / $371.54	Professional		$141.25	$218.78	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $61.66	Professional	26	$23.99	$35.48	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $181.97 / $302.00	Professional	TC	$114.82	$181.97	$302.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $338.84	Professional		$144.54	$223.87	$338.84
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $41.69 / $61.66	Professional	26	$27.54	$41.69	$61.66
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $181.97 / $269.15	Professional	TC	$117.49	$181.97	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $218.78 / $416.87	Professional		$138.04	$218.78	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $39.81 / $74.13	Professional	26	$25.70	$39.81	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $181.97 / $309.03	Professional	TC	$109.65	$181.97	$309.03