Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.48 / $146.07 / $146.07	Facility	26	$65.48	$146.07	$146.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $219.22 / $574.45	Professional		$206.63	$219.22	$574.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $47.52 / $122.73	Professional	26	$44.14	$47.52	$122.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.75 / $198.37 / $451.72	Professional	TC	$161.75	$198.37	$451.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $34.54 / $143.50	Professional	26	$34.54	$34.54	$143.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.42 / $281.86 / $498.27	Professional		$248.42	$281.86	$498.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.34 / $49.18 / $78.06	Professional	26	$43.34	$49.18	$78.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $205.08 / $233.25 / $411.33	Professional	TC	$205.08	$233.25	$411.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.81 / $491.08 / $761.64	Professional		$292.81	$491.08	$761.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.01 / $80.08 / $120.57	Professional	26	$50.01	$80.08	$120.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.79 / $411.56 / $638.54	Professional	TC	$242.79	$411.56	$638.54
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $284.39 / $504.34 / $936.81	Professional		$284.39	$504.34	$936.81
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $49.62 / $85.83 / $153.15	Professional	26	$49.62	$85.83	$153.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $234.77 / $406.11 / $724.62	Professional	TC	$234.77	$406.11	$724.62
United Facility/Professional Professional Modifier Low / Median / High Price $277.89 / $446.41 / $943.48	Professional		$277.89	$446.41	$943.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.62 / $76.34 / $160.06	Professional	26	$49.62	$76.34	$160.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.65 / $386.55 / $775.74	Professional	TC	$244.65	$386.55	$775.74
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $220.58 / $273.52 / $389.10	Professional		$220.58	$273.52	$389.10
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $43.58 / $58.96	Professional	26	$36.61	$43.58	$58.96
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $183.96 / $220.75 / $317.33	Professional	TC	$183.96	$220.75	$317.33