Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $104.71 / $288.40	Facility	26	$91.20	$104.71	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $338.84 / $812.83	Professional		$234.42	$338.84	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $102.33 / $234.42	Professional	26	$52.48	$102.33	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $234.42 / $616.60	Professional	TC	$162.18	$234.42	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $275.42 / $380.19	Professional		$213.80	$275.42	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $69.18 / $173.78	Professional	26	$42.66	$69.18	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Professional	TC	$165.96	$165.96	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $416.87	Professional		$257.04	$302.00	$416.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $87.10	Professional	26	$53.70	$61.66	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $239.88 / $323.59	Professional	TC	$204.17	$239.88	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $489.78 / $794.33	Professional		$295.12	$489.78	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $107.15 / $177.83	Professional	26	$60.26	$107.15	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $389.05 / $616.60	Professional	TC	$234.42	$389.05	$616.60
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $467.74 / $691.83	Professional		$302.00	$467.74	$691.83
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $95.50 / $141.25	Professional	26	$63.10	$95.50	$141.25
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $371.54 / $549.54	Professional	TC	$239.88	$371.54	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $467.74 / $831.76	Professional		$302.00	$467.74	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $100.00 / $165.96	Professional	26	$58.88	$100.00	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $380.19 / $660.69	Professional	TC	$234.42	$380.19	$660.69