Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.96 / $80.42 / $80.42	Facility	26	$33.96	$80.42	$80.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.60 / $223.96 / $712.56	Professional		$179.60	$223.96	$712.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $25.24 / $73.61	Professional	26	$23.15	$25.24	$73.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $156.46 / $198.72 / $638.91	Professional	TC	$156.46	$198.72	$638.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.98 / $164.98 / $164.98	Professional		$164.98	$164.98	$164.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $28.98 / $28.98	Professional	26	$28.98	$28.98	$28.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.29 / $175.06 / $305.20	Professional		$154.29	$175.06	$305.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.64 / $25.69 / $41.89	Professional	26	$22.64	$25.69	$41.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.65 / $149.37 / $260.70	Professional	TC	$131.65	$149.37	$260.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.75 / $299.13 / $443.77	Professional		$181.75	$299.13	$443.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $42.09 / $62.84	Professional	26	$25.94	$42.09	$62.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.81 / $259.56 / $380.94	Professional	TC	$155.81	$259.56	$380.94
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $176.63 / $310.22 / $581.84	Professional		$176.63	$310.22	$581.84
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $44.84 / $80.00	Professional	26	$25.92	$44.84	$80.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $150.71 / $260.70 / $465.17	Professional	TC	$150.71	$260.70	$465.17
United Facility/Professional Professional Modifier Low / Median / High Price $181.32 / $276.52 / $561.55	Professional		$181.32	$276.52	$561.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $39.70 / $82.73	Professional	26	$28.01	$39.70	$82.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.05 / $250.53 / $478.83	Professional	TC	$165.05	$250.53	$478.83
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $145.60 / $182.13 / $250.69	Professional		$145.60	$182.13	$250.69
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $18.84 / $22.87 / $30.33	Professional	26	$18.84	$22.87	$30.33
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $113.53 / $140.78 / $215.03	Professional	TC	$113.53	$140.78	$215.03