Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.61 / $48.45 / $48.45	Facility	26	$15.61	$48.45	$48.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.43 / $134.32 / $324.58	Professional		$117.43	$134.32	$324.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $23.34 / $42.12	Professional	26	$15.62	$23.34	$42.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.81 / $109.25 / $284.31	Professional	TC	$101.81	$109.25	$284.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.86 / $28.18 / $72.39	Professional	26	$17.86	$28.18	$72.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.39 / $134.32 / $235.90	Professional		$118.39	$134.32	$235.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $24.96 / $37.29	Professional	26	$22.00	$24.96	$37.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.39 / $109.37 / $186.74	Professional	TC	$96.39	$109.37	$186.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.32 / $235.54 / $342.65	Professional		$139.32	$235.54	$342.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $32.83 / $62.03	Professional	26	$22.67	$32.83	$62.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.09 / $194.74 / $281.57	Professional	TC	$114.09	$194.74	$281.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $135.53 / $258.20 / $446.45	Professional		$135.53	$258.20	$446.45
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.18 / $43.56 / $77.72	Professional	26	$25.18	$43.56	$77.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $110.35 / $195.69 / $363.50	Professional	TC	$110.35	$195.69	$363.50
United Facility/Professional Professional Modifier Low / Median / High Price $147.19 / $236.61 / $441.82	Professional		$147.19	$236.61	$441.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $39.34 / $83.40	Professional	26	$21.97	$39.34	$83.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.78 / $176.83 / $359.10	Professional	TC	$123.78	$176.83	$359.10
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $114.36 / $129.63 / $194.46	Professional		$114.36	$129.63	$194.46
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $20.72 / $28.26	Professional	26	$13.79	$20.72	$28.26
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $85.12 / $105.55 / $161.22	Professional	TC	$85.12	$105.55	$161.22