Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.58 / $104.66 / $287.12	Facility	26	$73.58	$104.66	$287.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $252.75 / $686.49	Professional		$246.93	$252.75	$686.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.95 / $91.13 / $235.18	Professional	26	$53.95	$91.13	$235.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.62 / $198.37 / $481.55	Professional	TC	$161.62	$198.37	$481.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.41 / $204.64 / $615.32	Professional		$193.41	$204.64	$615.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $60.13 / $172.79	Professional	26	$39.95	$60.13	$172.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $252.63 / $286.63 / $504.23	Professional		$252.63	$286.63	$504.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $59.45 / $103.01	Professional	26	$52.40	$59.45	$103.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $200.22 / $227.17 / $359.87	Professional	TC	$200.22	$227.17	$359.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.20 / $513.41 / $732.36	Professional		$297.20	$513.41	$732.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.21 / $105.41 / $163.32	Professional	26	$60.21	$105.41	$163.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.00 / $404.54 / $586.35	Professional	TC	$237.00	$404.54	$586.35
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $289.20 / $512.87 / $952.65	Professional		$289.20	$512.87	$952.65
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $59.99 / $103.77 / $185.16	Professional	26	$59.99	$103.77	$185.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $229.22 / $396.50 / $707.49	Professional	TC	$229.22	$396.50	$707.49
United Facility/Professional Professional Modifier Low / Median / High Price $321.24 / $467.90 / $950.19	Professional		$321.24	$467.90	$950.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.47 / $103.93 / $192.84	Professional	26	$66.47	$103.93	$192.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.06 / $432.66 / $757.35	Professional	TC	$261.06	$432.66	$757.35
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $223.55 / $295.67 / $423.40	Professional		$223.55	$295.67	$423.40
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $61.59 / $96.05	Professional	26	$43.99	$61.59	$96.05
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $179.56 / $215.47 / $340.09	Professional	TC	$179.56	$215.47	$340.09