Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.14 / $73.01 / $73.01	Facility	26	$23.14	$73.01	$73.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.97 / $205.77 / $511.43	Professional		$183.97	$205.77	$511.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $37.10 / $66.63	Professional	26	$23.14	$37.10	$66.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.75 / $174.43 / $451.72	Professional	TC	$161.75	$174.43	$451.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.44 / $30.36 / $69.48	Professional	26	$29.44	$30.36	$69.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.84 / $216.53 / $377.70	Professional		$190.84	$216.53	$377.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $41.10 / $60.52	Professional	26	$36.22	$41.10	$60.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.62 / $175.43 / $279.48	Professional	TC	$154.62	$175.43	$279.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.52 / $358.01 / $548.63	Professional		$224.52	$358.01	$548.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $52.94 / $100.74	Professional	26	$34.64	$52.94	$100.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.97 / $307.51 / $447.90	Professional	TC	$182.97	$307.51	$447.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $218.48 / $388.28 / $719.70	Professional		$218.48	$388.28	$719.70
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 $177.00 / $306.17 / $583.05	Professional	TC	$177.00	$306.17	$583.05
United Facility/Professional Professional Modifier Low / Median / High Price $210.40 / $337.59 / $713.48	Professional		$210.40	$337.59	$713.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $64.28 / $134.74	Professional	26	$36.04	$64.28	$134.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $176.33 / $282.35 / $577.59	Professional	TC	$176.33	$282.35	$577.59
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $206.47 / $293.72	Professional		$171.22	$206.47	$293.72
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.74 / $46.01	Professional	26	$20.89	$33.74	$46.01
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $135.84 / $168.44 / $257.27	Professional	TC	$135.84	$168.44	$257.27